Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 226300000X | Kinesiotherapist |
NPI | 1922438340 |
---|---|
Provider Name | Mr. Brian Hudson |
First Address | Murfreesboro, TN 37129 |
Second Address | Murfreesboro, TN 37129 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/11/2013 |
Last Update Date | 21/11/2013 |