Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225200000X | Physical Therapy Assistant | 5502005628 | MI |
NPI | 1013483593 |
---|---|
Provider Name | Emily Steenbeke |
First Address | Edwardsburg, MI 49112-8736 |
Second Address | Cassopolis, MI 49031-9644 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/10/2018 |
Last Update Date | 22/10/2018 |