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Individual
EARLE MCKENZIE BANE III
Active
Individual
EARLE MCKENZIE BANE III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT,DPT,ATC,SCS,CSCS
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
MD25774
MD
225100000X
Physical Therapist
PT871911
DC
Other
Enumeration date
01/10/2016
Last updated
04/29/2024
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