Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251X0800X | Physical Therapist - Orthopedic | PT017539 |
NPI | 1003396243 |
---|---|
Provider Name | Emily Henry |
First Address | Columbus, OH 43213-3194 |
Second Address | Columbus, OH 43213-3194 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/08/2018 |
Last Update Date | 17/08/2018 |