Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225200000X | Physical Therapy Assistant | A01102 | KY |
NPI | 1881842185 |
---|---|
Provider Name | Mrs. Kelly Elizabeth Coursey |
First Address | Calhoun, KY 42327 |
Second Address | Calhoun, KY 42327 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/08/2008 |
Last Update Date | 29/08/2008 |