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Individual
PHOEBE HAVILL
Active
Individual
PHOEBE HAVILL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, MPT, PCS, CKTP
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1161519
TX
2251P0200X
Pediatric Physical Therapist
1161519
TX
Other
Enumeration date
11/03/2011
Last updated
11/03/2011
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