| NPI | 1386218451 |
|---|---|
| Former Name | TESIA MARIE SMITH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MN 12328) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: AZ 30426) |
| Enumeration Date | 2021-05-13 |
| Last Update Date | 2021-08-03 |