NPI | 1407365133 |
---|---|
Former Name | LIDNSAY REGAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: MD 27554) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: PA PT026271) |
225100000X Physical Therapist (Licence: NY 049054) | |
Enumeration Date | 2017-09-26 |
Last Update Date | 2024-06-11 |