| 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 |