Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225100000X | Physical Therapist | 000713 | KY |
N | 225100000X | Physical Therapist | 05006654A | IN |
Y | 2251H1200X | Hand | 000713 | KY |
N | 2251H1200X | Hand | 05006654A | IN |
NPI | 1477543429 |
---|---|
Provider Name | Laurie Newsome |
First Address | Louisville, KY 40202-1846 |
Second Address | Louisville, KY 40202-1846 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/10/2005 |
Last Update Date | 21/10/2014 |