Individual
MRS. TALITHA SHAN WINQUIST
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
818 LOIS LN, BOWLING GREEN, KY 42104-4661
(270) 842-4038
Mailing address
818 LOIS LN, BOWLING GREEN, KY 42104-4661
(270) 842-4038
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT-001794
KY
Other
Enumeration date
09/21/2009
Last updated
09/21/2009
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