NPI | 1124688809 |
---|---|
Former Name | BETH ANNE ABBOTT |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: PA RT004941) |
Enumeration Date | 2019-06-16 |
Last Update Date | 2019-06-16 |