NPI | 1174172464 |
---|---|
Former Name | DANIELLE NICOLE PUCKETT |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: OH PT018945) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: HI 4896) |
Enumeration Date | 2019-09-09 |
Last Update Date | 2020-11-16 |