Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225200000X | Physical Therapy Assistant | 430 | NE |
NPI | 1013296417 |
---|---|
Provider Name | Mrs. Tasha Jo Nolting |
First Address | Murray, NE 68409-3372 |
Second Address | Nebraska City, NE 68410-1236 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/08/2011 |
Last Update Date | 16/08/2011 |