Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251G0304X | Physical Therapist - Geriatrics | 1134732 | TX |
NPI | 1013264209 |
---|---|
Provider Name | Kayla Whiddon |
First Address | Mckinney, TX 75070-4367 |
Second Address | Mckinney, TX 75070-4367 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/08/2012 |
Last Update Date | 04/04/2013 |