| NPI | 1215453469 |
|---|---|
| Former Name | LAUREN BLANCO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OH PT017721) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 041833) |
| Enumeration Date | 2017-08-19 |
| Last Update Date | 2019-12-15 |