Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225700000X | Massage Therapist | MT026908 | TX |
Y | 226300000X | Kinesiotherapist | 1560 | IL |
NPI | 1629231402 |
---|---|
Provider Name | Mr. Myron Washington |
First Address | Chillicothe, OH 45601-8608 |
Second Address | Chillicothe, OH 45601-8608 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/07/2008 |
Last Update Date | 02/07/2008 |