Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225100000X | Physical Therapist | 5707 | OH |
N | 2251G0304X | Physical Therapist - Geriatrics | 5707 | OH |
N | 2251N0400X | Physical Therapist - Neurology | 5707 | OH |
N | 2251P0200X | Physical Therapist - Pediatrics | 5707 | OH |
N | 2251S0007X | Physical Therapist - Sports | 5707 | OH |
N | 2251X0800X | Physical Therapist - Orthopedic | 5707 | OH |
NPI | 1780743252 |
---|---|
Provider Name | Mrs. Ladona Kay Mcmackin |
First Address | Ironton, OH 45638-2350 |
Second Address | Ironton, OH 45638-1548 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/12/2006 |
Last Update Date | 08/07/2007 |