Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251S0007X | Physical Therapist - Sports |
NPI | 1114284007 |
---|---|
Provider Name | Ms. Elizabeth Kathryn Yormick |
First Address | Syracuse, NY 13219-3009 |
Second Address | Syracuse, NY 13219-3009 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/04/2012 |
Last Update Date | 16/04/2012 |