| NPI | 1306151642 |
|---|---|
| Former Name | SAMANTHA LAFAYE WILLS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: VA 2305206573) |
| Enumeration Date | 2010-08-11 |
| Last Update Date | 2020-06-03 |