Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251N0400X | Physical Therapist - Neurology | PT31158 | FL |
NPI | 1003269069 |
---|---|
Provider Name | Ryann Cahill |
First Address | Jacksonville, FL 32216-4312 |
Second Address | Orange City, FL 32763-8321 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/07/2016 |
Last Update Date | 14/07/2016 |