| NPI | 1467085100 |
|---|---|
| Former Name | MACAULEY JANE BOHANNON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: GA CP004887T) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TN 12709) |
| Enumeration Date | 2020-02-21 |
| Last Update Date | 2021-05-12 |