Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225200000X | Physical Therapy Assistant | 99073305A | IN |
NPI | 1013366798 |
---|---|
Provider Name | Karen Blevins |
First Address | New Castle, IN 47362-9332 |
Second Address | Richmond, IN 47374-1500 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/06/2016 |
Last Update Date | 03/06/2016 |