NPI | 1497162283 |
---|---|
Former Name | CARRIE AMANDA SKOW |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: AZ LPT-30136) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: OR 60613) |
Enumeration Date | 2014-07-14 |
Last Update Date | 2024-11-04 |