NPI | 1093972754 |
---|---|
Former Name | TRACY LOUISE ALLEN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: WI 64564-20) |
Additional Taxonomies | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: AZ 40852) |
2081S0010X Physical Medicine & Rehabilitation, Sports Medicine (Licence: AZ 40852) | |
2083B0002X Preventive Medicine, Obesity Medicine (Licence: WI 64564-20) | |
2083P0901X Preventive Medicine, Public Health & General Preventive Medicine (Licence: WI 64564-20) | |
Enumeration Date | 2008-05-20 |
Last Update Date | 2021-06-02 |