Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NR0400X | Rehabilitation Chiropractor | CH7977 | FL |
NPI | 1275745853 |
---|---|
Provider Name | Dr. Kathleen Leotta |
First Address | Tampa, FL 33603-2600 |
Second Address | Tampa, FL 33603-2600 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/05/2007 |
Last Update Date | 16/03/2010 |