Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251N0400X | Physical Therapist - Neurology | 0525 | NV |
NPI | 1649304312 |
---|---|
Provider Name | Janette Sibley |
First Address | Pahrump, NV 89061-8251 |
Second Address | Pahrump, NV 89061-8251 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/03/2007 |
Last Update Date | 02/10/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
003402046 | (05) | NV |