| NPI | 1376562363 |
|---|---|
| Former Name | MICHELLE ANN FORD |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: AZ 6410) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CA PT22616) |
| Enumeration Date | 2006-07-19 |
| Last Update Date | 2007-07-08 |