Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225200000X | Physical Therapy Assistant | 2112666 | TX |
NPI | 1003267105 |
---|---|
Provider Name | Kelsey Hartensteiner |
First Address | Flatonia, TX 78941-2535 |
Second Address | Flatonia, TX 78941-2535 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/06/2016 |
Last Update Date | 29/06/2016 |