Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 05006891A | IN |
NPI | 1003064494 |
---|---|
Provider Name | Maureen Eve |
First Address | Corydon, IN 47112-1718 |
Second Address | Corydon, IN 47112-1718 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/08/2008 |
Last Update Date | 28/08/2008 |