NPI | 1386891505 |
---|---|
Former Name | MARY K BREENE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: WA PT60035309) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: CA 35167) |
Enumeration Date | 2008-08-19 |
Last Update Date | 2016-01-07 |