Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 1092559 | TX |
NPI | 1003168790 |
---|---|
Provider Name | Jennifer Duggins |
First Address | San Antonio, TX 78258-3509 |
Second Address | San Antonio, TX 78258-3509 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/10/2012 |
Last Update Date | 03/04/2017 |