Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225100000X | Physical Therapist | 002102 | GA |
N | 2251H1200X | Hand | 002102 | GA |
NPI | 1780643023 |
---|---|
Provider Name | Elisabeth Gay Rice |
First Address | Dalton, GA 30721 |
Second Address | Dalton, GA 30721 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/03/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
12612600 | PALMETTO (01) | |
526730 | BLUE CROSS BLUE SHIELD (01) | GA |