Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 226300000X | Kinesiotherapist |
NPI | 1780642728 |
---|---|
Provider Name | Miss Kasey Marie Dorris |
First Address | Spokane, WA 99207-2025 |
Second Address | Spokane, WA 99202-1330 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/05/2006 |
Last Update Date | 08/07/2007 |