Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 226300000X | Kinesiotherapist |
NPI | 1174030175 |
---|---|
Provider Name | Mr. Alexander Scott |
First Address | Troy, MI 48084 |
Second Address | Troy, MI 48084 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/12/2017 |
Last Update Date | 29/12/2017 |