Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | PT.013995 | OH |
N | 225100000X | Physical Therapist | PT014361 | GA |
NPI | 1003168410 |
---|---|
Provider Name | Kristen Leigh Arveson |
First Address | Hummelstown, PA 17036-8621 |
Second Address | Cincinnati, OH 45227-3429 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/10/2012 |
Last Update Date | 11/11/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0076016 | (05) | OH |
2565399 | (05) | OH |