NPI | 1124471602 |
---|---|
Former Name | TIFFANY BEUVING |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: OK 5496) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: CA 34002) |
Enumeration Date | 2016-07-19 |
Last Update Date | 2020-07-17 |