| NPI | 1285900720 |
|---|---|
| Former Name | MICHELLE LYNN WEINACHT |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NE 1876) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IA 03150) |
| Enumeration Date | 2012-03-29 |
| Last Update Date | 2012-03-29 |