Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 010707 | OH |
NPI | 1003152802 |
---|---|
Provider Name | Kathryn Ayers Kantura |
First Address | Cleveland, OH 44124-4190 |
Second Address | Cleveland, OH 44124-4190 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/12/2012 |
Last Update Date | 26/12/2012 |