| NPI | 1134743388 |
|---|---|
| Former Name | BETHANY DIETZ |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OH CP021820T) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TN 12785) |
| 225100000X Physical Therapist | |
| Enumeration Date | 2020-06-03 |
| Last Update Date | 2023-12-14 |