Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 226300000X | Kinesiotherapist | 039048 | KY |
NPI | 1649747882 |
---|---|
Provider Name | Ms. Tanika L. Owens |
First Address | Louisville, KY 40210-1517 |
Second Address | Louisville, KY 40210-1517 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/10/2018 |
Last Update Date | 25/10/2018 |