Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251G0304X | Physical Therapist - Geriatrics | 2010034269 | MO |
NPI | 1205224342 |
---|---|
Provider Name | Mrs. Naomi Mayfield |
First Address | Kansas City, MO 64137-3201 |
Second Address | Kansas City, MO 64137-3201 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/12/2014 |
Last Update Date | 23/12/2014 |