Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 226300000X | Kinesiotherapist |
NPI | 1891748596 |
---|---|
Provider Name | Ms. Bevelyn Kay Grindle |
First Address | Hampton, VA 23667-0001 |
Second Address | Dallas, TX 75216-7167 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/05/2006 |
Last Update Date | 13/05/2021 |