NPI | 1275515413 |
---|---|
Former Name | CHRISTINA MAYO |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: KY 004468) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: OH PT 10035) |
225100000X Physical Therapist (Licence: WV 002514) | |
Enumeration Date | 2005-11-15 |
Last Update Date | 2007-07-09 |