| NPI | 1205302163 |
|---|---|
| Former Name | AMY LYNN RENSLO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CA 295016) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CA PT295016) |
| Enumeration Date | 2018-10-18 |
| Last Update Date | 2020-07-22 |