Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | J10001504 | DE |
N | 2251E1200X | Ergonomics | J10001504 | DE |
N | 225XE1200X | Ergonomics | J10001504 | DE |
N | 2251G0304X | Physical Therapist - Geriatrics | J10001504 | DE |
N | 2251S0007X | Physical Therapist - Sports | J10001504 | DE |
N | 2251X0800X | Physical Therapist - Orthopedic | J10001504 | DE |
NPI | 1184687238 |
---|---|
Provider Name | Richard Hayward |
First Address | Lewes, DE 19958-4787 |
Second Address | Lewes, DE 19958-4787 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/04/2006 |
Last Update Date | 08/04/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2622967000 | AMERIHEALTH (01) | DE |
P89772 | (02) | DE |