Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251N0400X | Physical Therapist - Neurology | 10636 | OH |
NPI | 1376750489 |
---|---|
Provider Name | Mrs. Sara Young |
First Address | Dayton, OH 45414-3768 |
Second Address | Dayton, OH 45414-3768 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/05/2007 |
Last Update Date | 08/07/2007 |