Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251P0200X | Physical Therapist - Pediatrics | 2305203091 | VA |
NPI | 1003025040 |
---|---|
Provider Name | Michelle Lynn Higgins |
First Address | Chesapeake, VA 23322-7555 |
Second Address | Chesapeake, VA 23320-1609 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/05/2007 |
Last Update Date | 08/07/2007 |