Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 110131 | TX |
NPI | 1114508553 |
---|---|
Provider Name | Karl Erik Hammer |
First Address | Austin, TX 78723-2836 |
Second Address | Austin, TX 78753-3354 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/04/2021 |
Last Update Date | 17/04/2021 |