NPI | 1053473710 |
---|---|
Former Name | TIFFANY A QUINLAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: WV WV002345) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: FL 28975) |
Enumeration Date | 2006-12-15 |
Last Update Date | 2021-06-03 |