Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251G0304X | Physical Therapist - Geriatrics | PT1515 | AR |
NPI | 1407050453 |
---|---|
Provider Name | Maria Gigi Floresca |
First Address | West Memphis, AR 72301-3876 |
Second Address | West Memphis, AR 72301-4109 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/06/2007 |
Last Update Date | 08/07/2007 |