Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251P0200X | Physical Therapist - Pediatrics | 5501002661 | MI |
NPI | 1033155825 |
---|---|
Provider Name | Mrs. Julie Ann Honeycutt |
First Address | Wyoming, MI 49418-9301 |
Second Address | Wyoming, MI 49418-9301 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/06/2006 |
Last Update Date | 08/07/2007 |