Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225200000X | Physical Therapy Assistant | 2062513 | TX |
NPI | 1003431388 |
---|---|
Provider Name | Elizabeth Harkness |
First Address | Nolanville, TX 76542 |
Second Address | Nolanville, TX 76559 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/06/2020 |
Last Update Date | 11/06/2020 |