| NPI | 1184176109 |
|---|---|
| Former Name | NICOLE CANNING |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: AZ LPT-033823) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CA 43065) |
| Enumeration Date | 2016-10-25 |
| Last Update Date | 2024-09-27 |