Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251P0200X | Physical Therapist - Pediatrics | 2305004375 | VA |
NPI | 1124515010 |
---|---|
Provider Name | Allison Carter |
First Address | Newport News, VA 23602-7525 |
Second Address | Newport News, VA 23601-2313 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/04/2018 |
Last Update Date | 17/04/2018 |