NPI | 1013475607 |
---|---|
Former Name | HALEY EVELY WILLIAMS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 225100000X Physical Therapist (Licence: SC 9559) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: NC 18608) |
225100000X Physical Therapist (Licence: MS PT7070) | |
Enumeration Date | 2019-03-04 |
Last Update Date | 2024-08-01 |