NPI | 1225460793 |
---|---|
Former Name | TAMMIE AZOLAS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: HI PT-5195) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: TX 1304187) |
225100000X Physical Therapist (Licence: NM PT5309) | |
225100000X Physical Therapist (Licence: NV 2871) | |
Enumeration Date | 2013-08-06 |
Last Update Date | 2022-04-20 |