NPI | 1396336087 |
---|---|
Former Name | TIFFANY LEANNE HERSTINE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: FL PTA29988) |
Additional Taxonomies | 225200000X Physical Therapy Assistant |
Enumeration Date | 2021-01-27 |
Last Update Date | 2024-02-22 |