NPI | 1134754039 |
---|---|
Former Name | TINA LYNN KREMER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: IA 03241) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: IL 070.012490) |
Enumeration Date | 2020-03-11 |
Last Update Date | 2021-03-22 |