Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XH1200X | Occupational Therapist - Hand | 609 | MT |
NPI | 1225335912 |
---|---|
Provider Name | K.lee Subik |
First Address | Livingston, MT 59047-8938 |
Second Address | Bozeman, MT 59715-8808 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/02/2011 |
Last Update Date | 16/02/2011 |