Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 226300000X | Kinesiotherapist |
NPI | 1063465367 |
---|---|
Provider Name | Ms. Dusti Julieanna O'berry |
First Address | Murfreesboro, TN 37130-3354 |
Second Address | Murfreesboro, TN 37129-1237 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/05/2006 |
Last Update Date | 08/07/2007 |