NPI | 1134650690 |
---|---|
Former Name | BETHANY N DIAMOND |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: MN 13751) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: WA PT60843631) |
2255A2300X Specialist/Technologist, Athletic Trainer (Licence: OH 004340) | |
Enumeration Date | 2017-03-25 |
Last Update Date | 2025-04-22 |