Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251G0304X | Physical Therapist - Geriatrics | 05009171A | IN |
NPI | 1033738661 |
---|---|
Provider Name | Jessica Major |
First Address | Indianapolis, IN 46259-7770 |
Second Address | Indianapolis, IN 46259-6833 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/04/2020 |
Last Update Date | 14/04/2020 |