NPI | 1033193438 |
---|---|
Former Name | PAMELA JEAN VANLEEWEN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | |
Primary Taxonomy | 225100000X Physical Therapist (Licence: OR 4855) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: CA 18749) |
225100000X Physical Therapist | |
Enumeration Date | 2005-11-30 |
Last Update Date | 2007-07-08 |