Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225100000X | Physical Therapist | 104693 | MO |
Y | 225100000X | Physical Therapist | 2735 | NV |
N | 2251G0304X | Physical Therapist - Geriatrics | 11-02196 | KS |
NPI | 1124114657 |
---|---|
Provider Name | Mr. Dan Huddart |
First Address | Henderson, NV 89012-2212 |
Second Address | Henderson, NV 89012-2212 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/10/2006 |
Last Update Date | 08/11/2018 |