Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist |
NPI | 1003283219 |
---|---|
Provider Name | Kelly Resha |
First Address | Franklin, TN 37067-7269 |
Second Address | Franklin, TN 37067-8233 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/08/2015 |
Last Update Date | 24/08/2015 |