NPI | 1134685605 |
---|---|
Former Name | LESA COLON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: CA PT296228) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: CA 296228) |
Enumeration Date | 2019-02-20 |
Last Update Date | 2022-03-18 |