Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225100000X | Physical Therapist | ||
N | 2251S0007X | Physical Therapist - Sports | ||
N | 2251X0800X | Physical Therapist - Orthopedic | ||
Y | 2251X0800X | Physical Therapist - Orthopedic | 2305206131 | VA |
NPI | 1285868307 |
---|---|
Provider Name | Peter Michael Doyle |
First Address | Fort Campbell, KY 42223-5318 |
Second Address | Fort Sam Houston, TX 78234-4504 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/05/2009 |
Last Update Date | 09/06/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2305206131 | VA PT LICENSE (01) | VA |