| NPI | 1215501028 |
|---|---|
| Former Name | BETH ANN BROESDER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IA 100188) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: IA 100188) |
| Enumeration Date | 2021-05-17 |
| Last Update Date | 2022-10-26 |