| NPI | 1184183360 |
|---|---|
| Former Name | MARY MCCORMICK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OH PT017758) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: KY 008091) |
| Enumeration Date | 2019-03-18 |
| Last Update Date | 2023-11-14 |