Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251X0800X | Physical Therapist - Orthopedic | PT000631 | KY |
N | 2251X0800X | Physical Therapist - Orthopedic | PT02527 | OH |
NPI | 1003993577 |
---|---|
Provider Name | David Warren Apts |
First Address | Ashland, KY 41105 |
Second Address | Ashland, KY 41102 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/11/2006 |
Last Update Date | 08/07/2007 |