| NPI | 1235106014 |
|---|---|
| Former Name | LAURA JO COFFIN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OR 2356) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CA 19501) |
| Enumeration Date | 2006-03-01 |
| Last Update Date | 2021-01-12 |