NPI | 1336994680 |
---|---|
Former Name | BROOKE ANN HALDEMAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1250045) |
Additional Taxonomies | 261QP2000X Clinic/Center, Physical Therapy (Licence: TX 1250045) |
Enumeration Date | 2024-04-20 |
Last Update Date | 2024-05-10 |