Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 024718 | NY |
NPI | 1003166554 |
---|---|
Provider Name | Mrs. Kathleen Mary Howard |
First Address | Depew, NY 14043-4783 |
Second Address | Depew, NY 14043-4783 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/09/2012 |
Last Update Date | 12/09/2012 |