Eddie Light

NPI #1275707911 in Haysville, Kansas

Provider Information

NPI Number: 1275707911
Entity Type: Individual
Name: Eddie Light
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Physical Therapy Assistant
Enumeration Date: Apr 14, 2008
Last Updated: Apr 14, 2008

Practice Location

Address: 981 FOREST CT
City: Haysville
State: Kansas
ZIP Code: 67060-1478
Phone: (316) 522-1095

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapy Assistant	225200000X	Primary

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