NPI | 1083956056 |
---|---|
Former Name | ASHLEE ELLEN SCALCUCCI |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: MN 8977) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: WI 12279-24) |
Enumeration Date | 2013-03-18 |
Last Update Date | 2014-10-14 |