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 |