Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251N0400X | Physical Therapist - Neurology | PT871296 | DC |
NPI | 1376935106 |
---|---|
Provider Name | Dr. John David Kofmehl |
First Address | Washington, DC 20002-6105 |
Second Address | Washington, DC 20010-2921 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/03/2015 |
Last Update Date | 03/03/2015 |