Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251X0800X | Physical Therapist - Orthopedic | 4074 | AZ |
NPI | 1003196635 |
---|---|
Provider Name | Dr. Jeffrey Scott Abernethy |
First Address | Scottsdale, AZ 85251-5600 |
Second Address | Scottsdale, AZ 85251-5600 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/08/2011 |
Last Update Date | 26/08/2011 |