Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225100000X | Physical Therapist | PT027727 | PA |
N | 2251S0007X | Physical Therapist - Sports | 296648 | CA |
Y | 2251S0007X | Physical Therapist - Sports | 31717 | AZ |
NPI | 1487209730 |
---|---|
Provider Name | Michelle Kazmier |
First Address | Phoenix, AZ 85050-4605 |
Second Address | Phoenix, AZ 85050-4605 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/08/2019 |
Last Update Date | 21/01/2022 |