NPI | 1326670282 |
---|---|
Former Name | COURTNEY CHACON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: NV A-1693) |
Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: CA 50518) |
Enumeration Date | 2020-02-09 |
Last Update Date | 2024-07-15 |