Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 226300000X | Kinesiotherapist | 1903 | MS |
NPI | 1609334788 |
---|---|
Provider Name | Shelli Garner |
First Address | Austin, TX 78704-1117 |
Second Address | Austin, TX 78744-3111 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/03/2019 |
Last Update Date | 07/03/2019 |