NPI | 1255811089 |
---|---|
Former Name | LEANNE CLIFFORD |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 225100000X Physical Therapist (Licence: MN 11450) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: MI 5501018697) |
Enumeration Date | 2018-08-21 |
Last Update Date | 2020-10-16 |