Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251P0200X | Physical Therapist - Pediatrics | 5640 | OK |
NPI | 1083227854 |
---|---|
Provider Name | Emma Katherine Niblett |
First Address | Oklahoma City, OK 73118-6420 |
Second Address | Thomas, OK 73669 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/08/2020 |
Last Update Date | 31/08/2020 |