NPI | 1013313535 |
---|---|
Former Name | LAURA ANN BOCK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: MN 9855) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: ND 1817) |
Enumeration Date | 2014-11-11 |
Last Update Date | 2021-10-22 |