| NPI | 1497145536 |
|---|---|
| Former Name | TIFFANY SUDOL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2251X0800X Physical Therapist, Orthopedic (Licence: CT 010303) |
| Additional Taxonomies | 2251S0007X Physical Therapist, Sports |
| 2251X0800X Physical Therapist, Orthopedic (Licence: NY 037938-1) | |
| Enumeration Date | 2015-01-28 |
| Last Update Date | 2021-01-30 |