Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 2413 | NE |
NPI | 1003027384 |
---|---|
Provider Name | Linda Lea Kneebone |
First Address | Jefferson, SD 57038-6820 |
Second Address | Jefferson, SD 57038-6820 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/05/2007 |
Last Update Date | 08/07/2007 |