NPI | 1477614378 |
---|---|
Former Name | PENNY E PICKELS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics (Licence: FL PT 24039) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: GA PT007503) |
Enumeration Date | 2006-12-13 |
Last Update Date | 2013-05-22 |