Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251X0800X | Physical Therapist - Orthopedic | 1402130 | KS |
NPI | 1073829727 |
---|---|
Provider Name | Erin Willard |
First Address | Topeka, KS 66615-1004 |
Second Address | Topeka, KS 66615-1004 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/08/2010 |
Last Update Date | 19/08/2010 |