Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251N0400X | Physical Therapist - Neurology | 002079 | KY |
NPI | 1366691701 |
---|---|
Provider Name | Patricia A Sallee |
First Address | Louisville, KY 40202-5700 |
Second Address | Louisville, KY 40202-5700 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/09/2008 |
Last Update Date | 10/09/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
002079 | KENTUCKY STATE BOARD OF PHYSICAL THERAPY (01) | KY |