Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208100000X | Physical Medicine & Rehabilitation Doctor | PT03332. | RI |
Y | 225100000X | Physical Therapist |
NPI | 1053928226 |
---|---|
Provider Name | Kathleen Elizabeth Lott |
First Address | Providence, RI 02908-4934 |
Second Address | Wakefield, RI 02879-3176 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/09/2020 |
Last Update Date | 12/08/2021 |