NPI | 1366653693 |
---|---|
Former Name | JOAN ELIZABETH FREEMAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 225100000X Physical Therapist (Licence: NC 11105) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: WI 10698-24) |
Enumeration Date | 2007-05-25 |
Last Update Date | 2007-07-08 |