| NPI | 1033193438 |
|---|---|
| Former Name | PAMELA JEAN VANLEEWEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OR 4855) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IL 070001583) |
| 225100000X Physical Therapist (Licence: CA 18749) | |
| Enumeration Date | 2005-11-30 |
| Last Update Date | 2007-07-08 |