| NPI | 1295124824 |
|---|---|
| Former Name | SADIE JO COFFER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: TN 1297) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: TN 8143) |
| Enumeration Date | 2015-01-20 |
| Last Update Date | 2015-01-20 |