Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 226300000X | Kinesiotherapist |
NPI | 1871091470 |
---|---|
Provider Name | Mr. John Kenneth Purvis |
First Address | Murfreesboro, TN 37129-3093 |
Second Address | Murfreesboro, TN 37129-1392 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/01/2018 |
Last Update Date | 29/01/2018 |