NPI | 1194715714 |
---|---|
Former Name | ERIN L. FULLER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1154993) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: MD 22769) |
225100000X Physical Therapist (Licence: HI PT-2517) | |
225100000X Physical Therapist (Licence: FL PT20753) | |
Enumeration Date | 2005-10-25 |
Last Update Date | 2020-07-23 |