Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 226300000X | Kinesiotherapist |
NPI | 1043541378 |
---|---|
Provider Name | Mr. Stephen Burnice Nunnelley |
First Address | Hampton, VA 23667 |
Second Address | Hampton, VA 23667 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/01/2010 |
Last Update Date | 27/01/2010 |