Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225700000X | Massage Therapist | 008113 | TX |
N | 226300000X | Kinesiotherapist |
NPI | 1194029363 |
---|---|
Provider Name | Mrs. Kathy L Richburg |
First Address | Irving, TX 75061-1902 |
Second Address | Dallas, TX 75231-3401 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/01/2011 |
Last Update Date | 03/01/2011 |