Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0019X | Occupational Therapist - Physical Rehabilitation |
NPI | 1285918417 |
---|---|
Provider Name | David Allen Kashdan |
First Address | Lagrange, KY 40031-9085 |
Second Address | La Grange, KY 40031-9086 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/10/2011 |
Last Update Date | 06/10/2011 |