Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225100000X | Physical Therapist | ||
N | 2251P0200X | Physical Therapist - Pediatrics |
NPI | 1043321813 |
---|---|
Provider Name | Nancy Jane Mason |
First Address | Midland, TX 79705-6248 |
Second Address | Midland, TX 79705-6248 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/08/2006 |
Last Update Date | 09/07/2007 |