Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 226300000X | Kinesiotherapist | 1089 | VA |
NPI | 1396754768 |
---|---|
Provider Name | Mrs. Jill Diane Umstead |
First Address | Butler, PA 16001-8564 |
Second Address | Butler, PA 16001-2418 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/08/2006 |
Last Update Date | 08/07/2007 |