Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225100000X | Physical Therapist | 5366 | SC |
Y | 225100000X | Physical Therapist | PT29729 | FL |
NPI | 1003177627 |
---|---|
Provider Name | Kristen Honeycutt Downey |
First Address | Port Charlotte, FL 33952-4384 |
Second Address | Port Charlotte, FL 33952-4384 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/05/2012 |
Last Update Date | 23/01/2015 |