Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 10652 | TN |
NPI | 1003222324 |
---|---|
Provider Name | Emily Bolthouse |
First Address | Franklin, TN 37067-1631 |
Second Address | Franklin, TN 37067-1631 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/07/2014 |
Last Update Date | 31/03/2017 |