| NPI | 1205165701 |
|---|---|
| Former Name | HEATHER STANGE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NC 14290) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 026197) |
| Enumeration Date | 2009-12-11 |
| Last Update Date | 2022-03-03 |