Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251P0200X | Physical Therapist - Pediatrics | 1278750 | TX |
NPI | 1033660105 |
---|---|
Provider Name | Camille Kaiser |
First Address | Dallas, TX 75234-1927 |
Second Address | Dallas, TX 75234-1927 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/10/2016 |
Last Update Date | 24/10/2016 |