NPI | 1194075812 |
---|---|
Former Name | MELISSA ANN MITCHELL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1241450) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: AL PTH6599) |
225100000X Physical Therapist (Licence: TN 9217) | |
Enumeration Date | 2012-09-11 |
Last Update Date | 2015-04-15 |