| NPI | 1457546491 |
|---|---|
| Former Name | AMY CHRISTINE ECKERSTROM |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: MN A1276) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: NC 3089) |
| Enumeration Date | 2007-09-12 |
| Last Update Date | 2024-07-23 |