NPI | 1235406182 |
---|---|
Former Name | MEREDITH MICHELE WAHL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 225100000X Physical Therapist (Licence: 1207768) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: CA 39820) |
Enumeration Date | 2011-11-21 |
Last Update Date | 2018-03-17 |