Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 005158 | KY |
NPI | 1003016031 |
---|---|
Provider Name | Marjorie Lee Hall |
First Address | Corbin, KY 40701-1895 |
Second Address | Corbin, KY 40701-1895 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/07/2007 |
Last Update Date | 18/07/2007 |