NPI | 1114239779 |
---|---|
Former Name | JILLIAN KATE SALAS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 225100000X Physical Therapist (Licence: GA PT013371) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: NC 15271) |
Enumeration Date | 2010-07-11 |
Last Update Date | 2018-08-20 |