Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251P0200X | Physical Therapist - Pediatrics | 3498 | NC |
NPI | 1003139098 |
---|---|
Provider Name | Emmy Gardner Isbell |
First Address | Hertford, NC 27944-8274 |
Second Address | Hertford, NC 27944-8274 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/03/2010 |
Last Update Date | 05/03/2010 |