| NPI | 1083867873 |
|---|---|
| Former Name | LAURA ENNIS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MI 5501014115) |
| Additional Taxonomies | 225100000X Physical Therapist |
| Enumeration Date | 2008-10-24 |
| Last Update Date | 2015-05-29 |