Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225200000X | Physical Therapy Assistant | 06002509A | IN |
NPI | 1003275710 |
---|---|
Provider Name | Beth Voorhis |
First Address | Saint John, IN 46373-8878 |
Second Address | Burns Harbor, IN 46304-9727 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/02/2016 |
Last Update Date | 23/02/2016 |