NPI | 1164969366 |
---|---|
Former Name | AMANDA BLOCH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 225100000X Physical Therapist (Licence: CO PTL.0015435) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: CA 292621) |
Enumeration Date | 2017-01-25 |
Last Update Date | 2023-10-26 |