Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 226300000X | Kinesiotherapist | 1800 |
NPI | 1184926685 |
---|---|
Provider Name | Ms. Kimberly W White |
First Address | Dallas, TX 75216-7167 |
Second Address | Dallas, TX 75216-7167 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/12/2010 |
Last Update Date | 11/04/2012 |