NPI | 1235179847 |
---|---|
Former Name | PATRICIA GAYLE HEDRICK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: IA 00933) |
Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: MO 2020042536) |
Enumeration Date | 2006-06-08 |
Last Update Date | 2021-04-27 |