Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 226300000X | Kinesiotherapist | MASTER'S DEGREE | AZ |
NPI | 1649642463 |
---|---|
Provider Name | Shanna Holtz |
First Address | Scottsdale, AZ 85260 |
Second Address | Scottsdale, AZ 85260 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/10/2015 |
Last Update Date | 21/10/2015 |