Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225200000X | Physical Therapy Assistant | PTA001877 | WV |
NPI | 1003242074 |
---|---|
Provider Name | Mrs. Micki Lynn Townsend |
First Address | Parkersburg, WV 26101-7112 |
Second Address | Spencer, WV 25276-1035 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/09/2013 |
Last Update Date | 22/09/2013 |