| NPI | 1326151903 |
|---|---|
| Former Name | DEBRA JEAN MAIN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IL 070-013446) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TN 7639) |
| Enumeration Date | 2006-08-16 |
| Last Update Date | 2013-07-18 |