Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 226300000X | Kinesiotherapist | 1952 | MS |
NPI | 1104482173 |
---|---|
Provider Name | Mrs. Julia Marissa Thurman |
First Address | Biloxi, MS 39531-2410 |
Second Address | Pensacola, FL 32507-1000 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/05/2019 |
Last Update Date | 15/05/2019 |