Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 226300000X | Kinesiotherapist |
NPI | 1154946887 |
---|---|
Provider Name | Lisa Little |
First Address | Hines, IL 60141 |
Second Address | Hines, IL 60141 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/06/2020 |
Last Update Date | 09/06/2020 |