Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XH1200X | Occupational Therapist - Hand | 6917 | TN |
NPI | 1043980071 |
---|---|
Provider Name | Ryan York |
First Address | Chattanooga, TN 37402-2193 |
Second Address | Chattanooga, TN 37402-2193 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/09/2021 |
Last Update Date | 21/09/2021 |