Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251N0400X | Physical Therapist - Neurology | KY003572 | KY |
NPI | 1124566450 |
---|---|
Provider Name | Scott Schowalter |
First Address | Crestview Hills, KY 41017-5435 |
Second Address | Crestview Hills, KY 41017-5435 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/02/2017 |
Last Update Date | 07/02/2017 |