Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251G0304X | Physical Therapist - Geriatrics | 189753 | TX |
NPI | 1053893784 |
---|---|
Provider Name | Cindy Keisling Thomas |
First Address | Comfort, TX 78013-0885 |
Second Address | Kerrville, TX 78028-2851 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/08/2018 |
Last Update Date | 29/08/2018 |