NPI | 1073181517 |
---|---|
Former Name | MEGAN STORMS BUSH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 047841-01) |
Additional Taxonomies | 225100000X Physical Therapist |
Enumeration Date | 2021-06-11 |
Last Update Date | 2023-03-06 |