Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 226300000X | Kinesiotherapist |
NPI | 1326140724 |
---|---|
Provider Name | Mr. William Hunt Lofthouse |
First Address | Dekalb, IL 60115-2507 |
Second Address | Hines, IL 60141 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/09/2006 |
Last Update Date | 08/07/2007 |