NPI | 1205434354 |
---|---|
Former Name | COURTNEY LUENSMAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: WI 17071) |
Additional Taxonomies | 2251P0200X Physical Therapist, Pediatrics (Licence: MN 11768) |
Enumeration Date | 2020-10-12 |
Last Update Date | 2025-02-14 |