Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 001291 | KY |
NPI | 1003002502 |
---|---|
Provider Name | Carol G Adkins |
First Address | Owensboro, KY 42303-4455 |
Second Address | Owensboro, KY 42301-5300 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/09/2007 |
Last Update Date | 03/03/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000534468 | BLUE CROSS BLUE SHIELD (01) | KY |