Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225200000X | Physical Therapy Assistant | 06005471A | IN |
NPI | 1003388539 |
---|---|
Provider Name | Elizabeth Kate Allen-Scott |
First Address | Muncie, IN 47305-1812 |
Second Address | Muncie, IN 47305-1812 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/12/2018 |
Last Update Date | 21/12/2018 |