NPI | 1467717868 |
---|---|
Former Name | BROOKE JEAN LOVE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: PA PT025214) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: VT 0400086262) |
225100000X Physical Therapist (Licence: AZ LPT-010681) | |
Enumeration Date | 2012-07-11 |
Last Update Date | 2022-10-17 |