Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225100000X | Physical Therapist | 2305214020 | VA |
Y | 2251X0800X | Physical Therapist - Orthopedic | 2305214020 | VA |
NPI | 1023608478 |
---|---|
Provider Name | Zachary Thomas Splinter |
First Address | Virginia Beach, VA 23456-5437 |
Second Address | Virginia Beach, VA 23464-5368 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/01/2021 |
Last Update Date | 20/01/2021 |