Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225200000X | Physical Therapy Assistant | A00351 | KY |
NPI | 1013252204 |
---|---|
Provider Name | Mrs. Lisa Lair Hubsch |
First Address | Shelbyville, KY 40065-9702 |
Second Address | Frankfort, KY 40601 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/11/2012 |
Last Update Date | 29/11/2012 |