Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 070021286 | IL |
NPI | 1003208844 |
---|---|
Provider Name | Jamie Veith |
First Address | Quincy, IL 62301-4960 |
Second Address | Quincy, IL 62301-4960 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/03/2015 |
Last Update Date | 03/03/2015 |