NPI | 1144209347 |
---|---|
Former Name | HEIDI BEASLEY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: AZ LPT-002419) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: AZ 2419) |
Enumeration Date | 2006-01-16 |
Last Update Date | 2022-05-23 |