Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 05008179A | IN |
NPI | 1003169087 |
---|---|
Provider Name | Alyssa Seger |
First Address | Louisville, KY 40222-5185 |
Second Address | Louisville, KY 40222-5185 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/10/2012 |
Last Update Date | 16/10/2012 |