NPI | 1467824532 |
---|---|
Former Name | JOY CELESTE RUCKER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: GA PT012387) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: TN 10362) |
Enumeration Date | 2015-10-28 |
Last Update Date | 2023-06-08 |