Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 2233 | AL |
NPI | 1205221074 |
---|---|
Provider Name | Karen Weston |
First Address | Loxley, AL 36551-7574 |
Second Address | Loxley, AL 36551-7574 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/03/2015 |
Last Update Date | 30/03/2015 |