Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 3285 | NV |
NPI | 1003275231 |
---|---|
Provider Name | Kelsey Zane Daniels |
First Address | Las Vegas, NV 89145-0397 |
Second Address | Las Vegas, NV 89118-3334 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/02/2016 |
Last Update Date | 26/10/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
472546455 | (05) | NV |