| NPI | 1033888680 |
|---|---|
| Former Name | LAURA ELAINE JOHNSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NC P21658) |
| Additional Taxonomies | 225100000X Physical Therapist |
| Enumeration Date | 2021-09-08 |
| Last Update Date | 2022-10-20 |