Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251X0800X | Physical Therapist - Orthopedic | PTH3306 | AL |
NPI | 1033167267 |
---|---|
Provider Name | Mrs. Amy Forsyth Walsh |
First Address | Mobile, AL 36689-6144 |
Second Address | Mobile, AL 36608-3143 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/05/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
P01602 | (02) |