NPI | 1114068244 |
---|---|
Former Name | REBECCA D SWANSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: MN 2315) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: WI 3685) |
Enumeration Date | 2007-02-10 |
Last Update Date | 2021-09-13 |