NPI | 1538137906 |
---|---|
Former Name | TIFFANY NICOLE REED |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: LA PA.200073) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: LA TPA149) |
Enumeration Date | 2006-03-10 |
Last Update Date | 2025-08-29 |