Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251N0400X | Physical Therapist - Neurology | 006377 | KY |
NPI | 1487239190 |
---|---|
Provider Name | Mrs. Christy Dawn White |
First Address | Louisville, KY 40207-4702 |
Second Address | Louisville, KY 40207-4702 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/03/2021 |
Last Update Date | 15/03/2021 |