Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225200000X | Physical Therapy Assistant | 2107991 | TX |
NPI | 1003334756 |
---|---|
Provider Name | Kelly Trowell Kinder |
First Address | Argyle, TX 76226 |
Second Address | Argyle, TX 76226-6950 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/09/2017 |
Last Update Date | 01/09/2017 |