| NPI | 1497302244 |
|---|---|
| Former Name | WHITNEY MARIE PETERSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: ID PT-9200) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WY 2031) |
| 225100000X Physical Therapist (Licence: UT 13908430-2401) | |
| Enumeration Date | 2019-08-26 |
| Last Update Date | 2024-08-05 |