Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2251G0304X | Physical Therapist - Geriatrics | 002803 | WV |
N | 2251G0304X | Physical Therapist - Geriatrics | 005030 | KY |
Y | 2251G0304X | Physical Therapist - Geriatrics | 011678 | OH |
NPI | 1083985444 |
---|---|
Provider Name | Katrina Jean Rollins |
First Address | Ashland, KY 41102-5827 |
Second Address | Ashland, KY 41102-5827 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/01/2012 |
Last Update Date | 18/01/2012 |