| NPI | 1083276315 |
|---|---|
| Former Name | LAUREN MICHELLE BRIDGEWATER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MO 2020023324) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TN 12288) |
| Enumeration Date | 2019-07-08 |
| Last Update Date | 2022-01-31 |