Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251P0200X | Physical Therapist - Pediatrics | 3119233 | TX |
NPI | 1104274570 |
---|---|
Provider Name | Ashley Bartek |
First Address | Temple, TX 76502-5888 |
Second Address | Temple, TX 76502-5888 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/05/2016 |
Last Update Date | 03/10/2018 |