Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251X0800X | Physical Therapist - Orthopedic | 046285-01 | NY |
NPI | 1023618121 |
---|---|
Provider Name | Caitlin Taylor Corrice |
First Address | Watertown, NY 13601-0519 |
Second Address | Pulaski, NY 13142-1400 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/10/2020 |
Last Update Date | 28/10/2020 |