NPI | 1285178111 |
---|---|
Former Name | ALYSSA JEAN RACHUBKA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: CO 15831) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: MO 2016039469) |
Enumeration Date | 2016-12-12 |
Last Update Date | 2018-10-17 |