Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251N0400X | Physical Therapist - Neurology | 01359 | OR |
NPI | 1366921652 |
---|---|
Provider Name | Mrs. Carolyn A Piatt |
First Address | Medford, OR 97504-6241 |
Second Address | Medford, OR 97504-6241 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/08/2018 |
Last Update Date | 08/08/2018 |