NPI | 1457710170 |
---|---|
Former Name | HEATHER DORGAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: MI 5501010546) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: FL PT28710) |
Enumeration Date | 2016-02-23 |
Last Update Date | 2018-05-01 |