Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NX0800X | Chiropractor Orthopedic Specialist | CHOOOO1907 | WA |
NPI | 1427156058 |
---|---|
Provider Name | Dr. Keith O. Hoyt |
First Address | Mount Vernon, WA 98273-3281 |
Second Address | Mount Vernon, WA 98273-3281 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/09/2006 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
95425 | LI PROVIDER NUMBER (01) | WA |