NPI | 1164624359 |
---|---|
Former Name | STEPHANIE ANN BLOOMFIELD |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: IN 05009875A) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: TX 1172308) |
Enumeration Date | 2007-06-01 |
Last Update Date | 2012-12-19 |