NPI | 1033585062 |
---|---|
Former Name | BETHANY L HYDE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: MI 5501303281) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: MO 2015027115) |
Enumeration Date | 2015-08-13 |
Last Update Date | 2024-06-07 |