Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 226300000X | Kinesiotherapist |
NPI | 1871600221 |
---|---|
Provider Name | Mrs. Kathryn Ann Mckinley |
First Address | Holland, TX 76534-5075 |
Second Address | Temple, TX 76504-7451 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/08/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1279 | REGISTRATION (01) |