| NPI | 1225768161 |
|---|---|
| Former Name | MADELINE MOSHER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MN 12678) |
| Additional Taxonomies | 2251X0800X Physical Therapist, Orthopedic |
| Enumeration Date | 2022-06-14 |
| Last Update Date | 2025-11-13 |