| NPI | 1073914958 |
|---|---|
| Former Name | RACHEL JOHANSEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: DC PT872051) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NM 4497) |
| Enumeration Date | 2014-09-10 |
| Last Update Date | 2020-09-03 |