NPI | 1144608134 |
---|---|
Former Name | ALICIA SYMINGTON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: MN 11805) |
Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer |
Enumeration Date | 2015-05-11 |
Last Update Date | 2020-08-18 |