Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 226300000X | Kinesiotherapist | 1379 | AZ |
NPI | 1053421487 |
---|---|
Provider Name | Mr. James Martin Nance |
First Address | Tucson, AZ 85741-2644 |
Second Address | Tucson, AZ 85723-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/08/2006 |
Last Update Date | 06/09/2019 |