Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251S0007X | Physical Therapist - Sports | 1032357 | TX |
N | 2251X0800X | Physical Therapist - Orthopedic | 1032357 | TX |
NPI | 1043468515 |
---|---|
Provider Name | Michael G. Joseph |
First Address | Bryan, TX 77802-3499 |
Second Address | Bryan, TX 77802-3499 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/09/2008 |
Last Update Date | 27/07/2020 |