NPI | 1518785112 |
---|---|
Former Name | AMY SUZANNE BARLAGE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics (Licence: MI 5501011299) |
Additional Taxonomies | 2251N0400X Physical Therapist, Neurology (Licence: MI 5501011299) |
2251X0800X Physical Therapist, Orthopedic (Licence: MI 5501011299) | |
Enumeration Date | 2024-10-01 |
Last Update Date | 2024-10-01 |