Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 226300000X | Kinesiotherapist | 1930 | MS |
NPI | 1598163701 |
---|---|
Provider Name | Rachel Taylor |
First Address | North Chicago, IL 60064-3048 |
Second Address | North Chicago, IL 60064-3048 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/12/2014 |
Last Update Date | 22/12/2014 |