Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251X0800X | Physical Therapist - Orthopedic | 3696 | NV |
NPI | 1023517752 |
---|---|
Provider Name | Austin Webster |
First Address | Reno, NV 89511-3318 |
Second Address | Reno, NV 89511-3318 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/02/2018 |
Last Update Date | 08/02/2018 |