Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251P0200X | Physical Therapist - Pediatrics | 05011823A | IN |
NPI | 1114303682 |
---|---|
Provider Name | Emma Salyer |
First Address | Evansville, IN 47715-7325 |
Second Address | Evansville, IN 47715-7325 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/08/2015 |
Last Update Date | 06/08/2015 |