NPI | 1386815405 |
---|---|
Former Name | AMY COLLEEN MOHAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: TN 9889) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: MO 2007032189) |
Enumeration Date | 2008-03-17 |
Last Update Date | 2014-02-04 |