NPI | 1508093279 |
---|---|
Former Name | MELANIE DIANE BERRY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: CO PTL0019649) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: KS T-02421) |
2251X0800X Physical Therapist, Orthopedic (Licence: NC 13665) | |
Enumeration Date | 2009-06-19 |
Last Update Date | 2024-03-06 |