Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 226300000X | Kinesiotherapist | 1596 | IL |
NPI | 1164638847 |
---|---|
Provider Name | Mr. Tony Lamont Curry |
First Address | Fayetteville, NC 28311-9212 |
Second Address | Fayetteville, NC 28301-3856 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/05/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1596 | KINESIOTHERAPIST (01) | IL |