| NPI | 1104229459 |
|---|---|
| Former Name | LAUREN QUEENAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MA 21310) |
| Additional Taxonomies | 2251X0800X Physical Therapist, Orthopedic (Licence: ME PT5416) |
| Enumeration Date | 2014-10-01 |
| Last Update Date | 2019-07-16 |