| NPI | 1386704500 |
|---|---|
| Former Name | HEATHER LAVELLE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OH 7040) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: PA 057250) |
| Enumeration Date | 2006-12-11 |
| Last Update Date | 2009-07-22 |