Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2251S0007X | Physical Therapist - Sports | ||
Y | 2251X0800X | Physical Therapist - Orthopedic |
NPI | 1447803374 |
---|---|
Provider Name | Seth Kneebone |
First Address | Redding, CA 96001-3634 |
Second Address | Redding, CA 96001-0814 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/07/2019 |
Last Update Date | 19/07/2019 |