| NPI | 1083673354 |
|---|---|
| Former Name | AMBER DAWN INGRAM |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305208453) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: HI 2556) |
| 225100000X Physical Therapist (Licence: NE 2391) | |
| Enumeration Date | 2006-03-23 |
| Last Update Date | 2024-09-13 |