NPI | 1417115866 |
---|---|
Former Name | LUCINDA MARIE DAVIS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: AL 4568) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: VA 2305205404) |
225100000X Physical Therapist (Licence: GA PT012299) | |
Enumeration Date | 2008-06-01 |
Last Update Date | 2021-08-11 |