Kathleen L Slade, PTA

NPI #1720151285 in Jackson, Wyoming

Provider Information

NPI Number: 1720151285
Entity Type: Individual
Name: Kathleen L Slade, PTA
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physical Therapy Assistant
Credential: PTA
Enumeration Date: Nov 15, 2006
Last Updated: Jul 8, 2007

Practice Location

Address: 1090 S HIGHWAY 89
City: Jackson
State: Wyoming
ZIP Code: 83001
Phone: (307) 733-5577

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapy Assistant	225200000X	Primary

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