Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NS0005X | Chiropractic Sports Physician | 4311 | TX |
NPI | 1245530880 |
---|---|
Provider Name | Dr. Kyle Scott Workman |
First Address | Livingston, TX 77351-6351 |
Second Address | Livingston, TX 77351-6351 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/10/2010 |
Last Update Date | 29/10/2010 |