Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | ||
N | 2251G0304X | Physical Therapist - Geriatrics | ||
N | 2251N0400X | Physical Therapist - Neurology | ||
N | 2251X0800X | Physical Therapist - Orthopedic |
NPI | 1467736579 |
---|---|
Provider Name | Kim Christie Paul-Marino |
First Address | Holyoke, MA 01040-4065 |
Second Address | Holyoke, MA 01040-4065 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/10/2011 |
Last Update Date | 11/09/2018 |