Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225100000X | Physical Therapist | 001934 | KY |
N | 225100000X | Physical Therapist | 05008055A | IN |
Y | 2251H1200X | Hand | 001934 | KY |
NPI | 1770573719 |
---|---|
Provider Name | Jaime Marie Royalty |
First Address | Louisville, KY 40201-7441 |
Second Address | Louisville, KY 40202-1846 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/10/2005 |
Last Update Date | 27/09/2016 |