NPI | 1023786167 |
---|---|
Former Name | PIPER LAUREL REYNOLDS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: OK 4949) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: FL 30366) |
225100000X Physical Therapist (Licence: VA 2305215427) | |
Enumeration Date | 2021-09-02 |
Last Update Date | 2024-09-24 |