NPI | 1043451495 |
---|---|
Former Name | SHANNON KRUGER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: MI 5501017661) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: IL 070-016974) |
Enumeration Date | 2009-03-16 |
Last Update Date | 2018-06-18 |