NPI | 1437387867 |
---|---|
Former Name | AMANDA CLAIRE WELLS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: OH PT014384) |
Additional Taxonomies | 2251S0007X Physical Therapist, Sports (Licence: IA 4411) |
225100000X Physical Therapist (Licence: WI 11629-24) | |
Enumeration Date | 2009-06-24 |
Last Update Date | 2014-10-03 |