NPI | 1003947987 |
---|---|
Former Name | COLYNN ANNE LABERGE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: MD 20796) |
Additional Taxonomies | 2251P0200X Physical Therapist, Pediatrics (Licence: MD 20796) |
Enumeration Date | 2007-03-09 |
Last Update Date | 2024-08-13 |