NPI | 1346023645 |
---|---|
Former Name | CASEY NICOLE DEMING |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: CO PTL.0019448) |
Additional Taxonomies | 2251X0800X Physical Therapist, Orthopedic (Licence: FL PT40541) |
Enumeration Date | 2023-08-18 |
Last Update Date | 2024-11-14 |