Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251P0200X | Physical Therapist - Pediatrics |
NPI | 1033765706 |
---|---|
Provider Name | Raven Ann Hunt |
First Address | Monaca, PA 15061-1317 |
Second Address | New Castle, PA 16105-1242 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/08/2019 |
Last Update Date | 17/08/2019 |