Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 226300000X | Kinesiotherapist | 1869 |
NPI | 1336498641 |
---|---|
Provider Name | Katelyn Marie Laux |
First Address | Monclova, OH 43542 |
Second Address | North Chicago, IL 60064 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/08/2012 |
Last Update Date | 31/08/2012 |