Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251N0400X | Physical Therapist - Neurology | 1342106 | TX |
NPI | 1740874734 |
---|---|
Provider Name | Dr. Hannah John |
First Address | Dallas, TX 75390-8876 |
Second Address | Dallas, TX 75235-7707 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/02/2021 |
Last Update Date | 22/02/2021 |