Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | TX | |
N | 2251G0304X | Physical Therapist - Geriatrics |
NPI | 1043790645 |
---|---|
Provider Name | Mrs. Nancy Michelle Hobbs |
First Address | Canton, TX 75103-8402 |
Second Address | Canton, TX 75103-8402 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/08/2018 |
Last Update Date | 14/08/2018 |