NPI | 1326195710 |
---|---|
Former Name | SUSAN ALFORD |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 225100000X Physical Therapist (Licence: CO PTL.0006257) |
Additional Taxonomies | 2251S0007X Physical Therapist, Sports (Licence: CO PTL.0006257) |
2255A2300X Specialist/Technologist, Athletic Trainer (Licence: CO AT.0000716) | |
Enumeration Date | 2007-01-05 |
Last Update Date | 2017-11-10 |