Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225200000X | Physical Therapy Assistant | ||
Y | 225200000X | Physical Therapy Assistant | 160004934 | IL |
NPI | 1003155649 |
---|---|
Provider Name | Kimberly Schmitt |
First Address | La Vernia, TX 78121-3955 |
Second Address | La Vernia, TX 78121-3955 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/02/2013 |
Last Update Date | 27/08/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
NA | (05) | TX |