NPI | 1003205436 |
---|---|
Former Name | AMANDA L LAND |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: OR 60884) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: WA 61154609) |
Enumeration Date | 2015-01-22 |
Last Update Date | 2022-04-29 |