Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | PT006651L | PA |
NPI | 1003236266 |
---|---|
Provider Name | Maureen Higgins |
First Address | Haddon Township, NJ 08108-1719 |
Second Address | Philadelphia, PA 19106-1554 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/04/2014 |
Last Update Date | 25/04/2014 |