Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251N0400X | Physical Therapist - Neurology | 007683 | KY |
NPI | 1760026744 |
---|---|
Provider Name | Kristina Marie Maus |
First Address | Lexington, KY 40508-2245 |
Second Address | Lexington, KY 40503-3594 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/11/2019 |
Last Update Date | 23/08/2020 |