Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251S0007X | Physical Therapist - Sports | 006265 | KY |
NPI | 1326336579 |
---|---|
Provider Name | Cassie Dawson |
First Address | Benton, KY 42025-1424 |
Second Address | Murray, KY 42071-2546 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/07/2011 |
Last Update Date | 30/01/2017 |