| NPI | 1487942231 |
|---|---|
| Former Name | MARY ANN NEUBELT |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CT 004655) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist Athletic Trainer (Licence: CT 000091) |
| Enumeration Date | 2011-07-14 |
| Last Update Date | 2011-07-14 |