Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225200000X | Physical Therapy Assistant | 31675 | FL |
NPI | 1003576794 |
---|---|
Provider Name | Kaitlin Elizabeth Myers |
First Address | Schenectady, NY 12308-1821 |
Second Address | Zephyrhills, FL 33542-5759 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/12/2021 |
Last Update Date | 22/12/2021 |