NPI | 1457736423 |
---|---|
Former Name | LAURA LEONA WEBB |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: CO PTL.0013744) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: IA 078667) |
225100000X Physical Therapist (Licence: KS 11-05157) | |
Enumeration Date | 2015-07-20 |
Last Update Date | 2021-08-18 |