Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225100000X | Physical Therapist | CT | |
N | 2251G0304X | Physical Therapist - Geriatrics | 4583 | NM |
Y | 2251X0800X | Physical Therapist - Orthopedic | 035754 | NY |
NPI | 1174904171 |
---|---|
Provider Name | Chiyou Ahn |
First Address | Sunrise, FL 33323-2860 |
Second Address | Sunrise, FL 33323-2860 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/06/2015 |
Last Update Date | 15/06/2015 |