Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 1182317 | TX |
NPI | 1992988281 |
---|---|
Provider Name | Mr. Christopher Michael Harty |
First Address | San Antonio, TX 78260-6279 |
Second Address | San Antonio, TX 78258-3944 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/12/2007 |
Last Update Date | 01/08/2008 |