Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 226300000X | Kinesiotherapist | 775 | TX |
NPI | 1578677753 |
---|---|
Provider Name | Randy Sefcik |
First Address | Temple, TX 76502-3133 |
Second Address | Temple, TX 76504-7451 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/08/2006 |
Last Update Date | 08/07/2007 |