Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225200000X | Physical Therapy Assistant | PTA0000003049 | TN |
NPI | 1013080506 |
---|---|
Provider Name | Mr. James Michael Houser JR. |
First Address | Knoxville, TN 37932-2078 |
Second Address | Nashville, TN 37203-1035 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/11/2006 |
Last Update Date | 08/07/2007 |