Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251X0800X | Physical Therapist - Orthopedic | 11-02375 | KS |
NPI | 1053523191 |
---|---|
Provider Name | Lovena Maria Stamatiou-Tuley |
First Address | Lawrence, KS 66049-1629 |
Second Address | Lawrence, KS 66044-1360 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/05/2007 |
Last Update Date | 08/07/2007 |