Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225200000X | Physical Therapy Assistant | 2126683 | TX |
NPI | 1003396722 |
---|---|
Provider Name | Vidhi Ghetia |
First Address | Wichita Falls, TX 76308-5389 |
Second Address | Burkburnett, TX 76354-3714 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/08/2018 |
Last Update Date | 21/08/2018 |