Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225200000X | Physical Therapy Assistant | A02364 | KY |
NPI | 1013129386 |
---|---|
Provider Name | Mrs. Carolyn Ann Gilhooly |
First Address | Fisherville, KY 40023-6463 |
Second Address | Louisville, KY 40220-4016 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/05/2007 |
Last Update Date | 30/01/2012 |