Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 7000660 | TX |
N | 2251X0800X | Physical Therapist - Orthopedic | 40QA0826300 | NJ |
NPI | 1043382013 |
---|---|
Provider Name | Mr. Nick Jaromahum |
First Address | Sugar Land, TX 77479-6759 |
Second Address | Sugar Land, TX 77479-6759 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/11/2006 |
Last Update Date | 04/11/2021 |