Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 9990 | CA |
NPI | 1255611174 |
---|---|
Provider Name | Mrs. Shana Kaye Furr |
First Address | Tracy, CA 95304-9760 |
Second Address | Tracy, CA 95376-2165 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/08/2011 |
Last Update Date | 23/08/2011 |