Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251N0400X | Physical Therapist - Neurology | 033820 | NY |
NPI | 1205129921 |
---|---|
Provider Name | Jacob Mcpherson |
First Address | Orchard Park, NY 14127-1524 |
Second Address | Orchard Park, NY 14127-2275 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/05/2011 |
Last Update Date | 15/09/2014 |