Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 1989 | NE |
N | 2251S0007X | Physical Therapist - Sports | 6602 | AZ |
N | 2251X0800X | Physical Therapist - Orthopedic | 6602 | AZ |
NPI | 1013261916 |
---|---|
Provider Name | Kenneth A Patterson |
First Address | Omaha, NE 68137 |
Second Address | Omaha, NE 68137 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/10/2012 |
Last Update Date | 07/08/2013 |