Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251X0800X | Physical Therapist - Orthopedic | 070.012856 | IL |
NPI | 1043579469 |
---|---|
Provider Name | Joyce Viola Briggs |
First Address | Lincolnshire, IL 60069-3094 |
Second Address | Lincolnshire, IL 60069-3094 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/05/2012 |
Last Update Date | 04/05/2012 |