Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225200000X | Physical Therapy Assistant | 06003004A | IN |
NPI | 1003158437 |
---|---|
Provider Name | Angela Kay Mayhill |
First Address | Louisville, KY 40222-5158 |
Second Address | Louisville, KY 40222-5158 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/03/2013 |
Last Update Date | 24/03/2013 |