NPI | 1225390776 |
---|---|
Former Name | JANICE M DIMMITT |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: KS 11-04342) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: MO 01726) |
Enumeration Date | 2012-06-11 |
Last Update Date | 2015-12-30 |