| NPI | 1376737114 |
|---|---|
| Former Name | JUAN MICHELLE BOVELL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251X0800X Physical Therapist, Orthopedic (Licence: GA 009599) |
| Additional Taxonomies | 2251X0800X Physical Therapist, Orthopedic (Licence: NY 029661) |
| Enumeration Date | 2007-09-05 |
| Last Update Date | 2016-03-17 |