NPI | 1356791198 |
---|---|
Former Name | LAURA ELIZABETH QUIST |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: MT 11078) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: CO PTL.0014020) |
Enumeration Date | 2016-06-13 |
Last Update Date | 2017-03-18 |