NPI | 1427274869 |
---|---|
Former Name | AMY BROOKE PEACH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2251X0800X Physical Therapist, Orthopedic (Licence: CA 27397) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: CA 27397) |
2251S0007X Physical Therapist, Sports (Licence: CA 27397) | |
2255A2300X Specialist/Technologist, Athletic Trainer (Licence: CO Cert # 099402403) | |
Enumeration Date | 2007-04-17 |
Last Update Date | 2013-07-15 |