Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251N0400X | Physical Therapist - Neurology |
NPI | 1194254771 |
---|---|
Provider Name | Dr. Virginia Hawley |
First Address | Kodak, TN 37764-1747 |
Second Address | Kodak, TN 37764-1747 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/06/2017 |
Last Update Date | 07/06/2017 |