Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 226300000X | Kinesiotherapist | 2101 | MS |
NPI | 1760099204 |
---|---|
Provider Name | Caitlyn Andree Pittman |
First Address | Richmond, VA 23225-7941 |
Second Address | Richmond, VA 23249-0001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/09/2020 |
Last Update Date | 29/09/2020 |