Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NS0005X | Chiropractic Sports Physician | 4138 | TX |
NPI | 1164645503 |
---|---|
Provider Name | Patricia A Felder |
First Address | Georgetown, TX 78628-2864 |
Second Address | Georgetown, TX 78628-2864 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/04/2007 |
Last Update Date | 08/07/2007 |