Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 1145886 | TX |
NPI | 1003032335 |
---|---|
Provider Name | Sarah Henry |
First Address | Dallas, TX 75248-3013 |
Second Address | Dallas, TX 75225-3523 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/04/2007 |
Last Update Date | 08/07/2007 |