Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225200000X | Physical Therapy Assistant | 3289 | MA |
NPI | 1003934092 |
---|---|
Provider Name | Miss Kathleen Doyle |
First Address | North Eastham, MA 02651-1690 |
Second Address | W Yarmouth, MA 02673-3200 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/03/2007 |
Last Update Date | 08/07/2007 |