Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251G0304X | Physical Therapist - Geriatrics | PT007191 | OH |
NPI | 1124067400 |
---|---|
Provider Name | Ms. Alice Dorworth Holder |
First Address | Cincinnati, OH 45231-5736 |
Second Address | Cincinnati, OH 45220-2213 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/06/2006 |
Last Update Date | 08/07/2007 |