NPI | 1235312109 |
---|---|
Former Name | CORI MARIE MCREYNOLDS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: CA 25840) |
Additional Taxonomies | 2251X0800X Physical Therapist, Orthopedic (Licence: CA 25840) |
Enumeration Date | 2007-12-13 |
Last Update Date | 2022-10-18 |