Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 11-04183 | KS |
NPI | 1003125741 |
---|---|
Provider Name | Holly Elizabeth Rauch |
First Address | Lawrence, KS 66049 |
Second Address | Lawrence, KS 66049 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/09/2010 |
Last Update Date | 29/09/2010 |