| NPI | 1508299496 |
|---|---|
| Former Name | TIRZAH GRACE DAVIS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CT 10703) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 036636) |
| Enumeration Date | 2013-08-14 |
| Last Update Date | 2016-04-06 |