Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 6597 | OR |
NPI | 1003198110 |
---|---|
Provider Name | Catherine Stone |
First Address | Bend, OR 97701-2877 |
Second Address | Bend, OR 97701-3535 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/09/2011 |
Last Update Date | 14/09/2011 |