NPI | 1023340130 |
---|---|
Former Name | GRETCHEN RENAE SPIES |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: IA 004656) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: IL 070-018208) |
Enumeration Date | 2010-02-01 |
Last Update Date | 2014-01-20 |