Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225100000X | Physical Therapist | 006085 | KY |
Y | 2251E1300X | Electrophysiology, Clinical | 006085 | KY |
NPI | 1265785661 |
---|---|
Provider Name | Dustin L Arthur |
First Address | Richmond, KY 40475-8322 |
Second Address | Richmond, KY 40475-2876 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/10/2012 |
Last Update Date | 09/01/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
7100235780 | (05) | KY |