Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251X0800X | Physical Therapist - Orthopedic | 105781 | MO |
NPI | 1053402396 |
---|---|
Provider Name | Kristina M Higgins |
First Address | Saint Louis, MO 63141-7030 |
Second Address | Saint Louis, MO 63141-7030 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/09/2006 |
Last Update Date | 08/07/2007 |