NPI | 1295373181 |
---|---|
Former Name | AMANDA MERCEDES MORCOM |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: NC P20068) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: WA PT60983464) |
Enumeration Date | 2019-12-11 |
Last Update Date | 2020-12-11 |