Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 226300000X | Kinesiotherapist | 1597 | IL |
NPI | 1619064078 |
---|---|
Provider Name | Sheilda Norwieta Perez |
First Address | Hampton, VA 23666-1828 |
Second Address | Hampton, VA 23667-0001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/10/2006 |
Last Update Date | 04/09/2013 |