| NPI | 1306980834 |
|---|---|
| Former Name | LISA MARIE BRACKMAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: CO PTA.0012393) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: WA P1 60415386) |
| 225200000X Physical Therapy Assistant (Licence: TX 2059028) | |
| 225200000X Physical Therapy Assistant (Licence: ID PTA-3689) | |
| Enumeration Date | 2007-02-17 |
| Last Update Date | 2018-04-06 |