Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 226300000X | Kinesiotherapist | CT |
NPI | 1952965196 |
---|---|
Provider Name | Kelsey Rankin |
First Address | Willington, CT 06279-1605 |
Second Address | Storrs, CT 06268 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/04/2019 |
Last Update Date | 23/04/2019 |