Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 204C00000X | Sports Medicine Doctor | 35300 | AZ |
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | 35300 | AZ |
NPI | 1972558427 |
---|---|
Provider Name | Mrs. Catherine A Foll |
First Address | Phoenix, AZ 85028 |
Second Address | Scottsdale, AZ 85251-5600 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/05/2006 |
Last Update Date | 16/06/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
116260 | (05) | AZ |
I-59062 | (02) | AZ |