| NPI | 1356786636 |
|---|---|
| Former Name | LAURA LYNN PETERSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251X0800X Physical Therapist Orthopedic (Licence: NC P14187) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NC 14187) |
| Enumeration Date | 2013-05-01 |
| Last Update Date | 2022-01-25 |