Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251G0304X | Physical Therapist - Geriatrics | 1666 | AR |
NPI | 1245441096 |
---|---|
Provider Name | Ms. Kathy Jo Gay |
First Address | Melbourne, AR 72556-0797 |
Second Address | Gassville, AR 72635-8529 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/05/2007 |
Last Update Date | 08/07/2007 |