| NPI | 1093232803 |
|---|---|
| Former Name | NICHOLE IMHOF |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OH PT019418) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NE 2024) |
| Enumeration Date | 2017-08-23 |
| Last Update Date | 2021-09-27 |