Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XH1200X | Occupational Therapist - Hand | 0119008726 | VA |
NPI | 1245843705 |
---|---|
Provider Name | Autumn Puryear |
First Address | Richmond, VA 23223-3533 |
Second Address | Winchester, VA 22601-2818 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/08/2020 |
Last Update Date | 25/08/2020 |