NPI | 1407537657 |
---|---|
Former Name | JANIS KATHLEEN DAVENPORT |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: FL PTA32927) |
Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: MD A4223) |
Enumeration Date | 2023-07-31 |
Last Update Date | 2023-07-31 |