NPI | 1285170688 |
---|---|
Former Name | TAYLOR CUNNINGHAM |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: PA PT025781) |
Additional Taxonomies | 2251P0200X Physical Therapist, Pediatrics (Licence: AZ 13499PT) |
Enumeration Date | 2017-01-10 |
Last Update Date | 2023-08-15 |