NPI | 1033291745 |
---|---|
Former Name | STEPHANIE E COUCH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 225100000X Physical Therapist (Licence: MO 2005026627) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: AZ 11996) |
Enumeration Date | 2006-10-20 |
Last Update Date | 2017-05-08 |