Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225200000X | Physical Therapy Assistant | 40QB00206300 | NJ |
NPI | 1013032044 |
---|---|
Provider Name | Mindy Sears |
First Address | East Windsor, NJ 08520-5362 |
Second Address | Monroe Twp, NJ 08831-3754 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/03/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
40QB00206300 | PTA (01) | NJ |