Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251P0200X | Physical Therapist - Pediatrics | 4076 | NE |
NPI | 1093323867 |
---|---|
Provider Name | Chelsea Silva |
First Address | Westmont, IL 60559-5548 |
Second Address | Omaha, NE 68116-2106 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/07/2020 |
Last Update Date | 10/09/2020 |