Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225400000X | Rehabilitation Practitioner |
NPI | 1003247289 |
---|---|
Provider Name | Linda Pope |
First Address | Pahrump, NV 89060-1339 |
Second Address | Pahrump, NV 89060-1339 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/12/2013 |
Last Update Date | 12/12/2013 |