Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 226300000X | Kinesiotherapist | 1108 | IL |
NPI | 1326344730 |
---|---|
Provider Name | Mr. David Martin Garcia |
First Address | Elmhurst, IL 60126 |
Second Address | North Chicago, IL 60064 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/02/2011 |
Last Update Date | 03/02/2011 |