Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251N0400X | Physical Therapist - Neurology |
NPI | 1710526785 |
---|---|
Provider Name | Kyle Lawrence Jones |
First Address | Bel Air, MD 21015-1798 |
Second Address | Bel Air, MD 21015-1798 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/12/2019 |
Last Update Date | 23/12/2019 |