NPI | 1366424608 |
---|---|
Former Name | ERIN K WORMUTH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305004031) |
Additional Taxonomies | 225000000X Orthotic Fitter |
Enumeration Date | 2005-11-14 |
Last Update Date | 2022-03-16 |