NPI | 1538477427 |
---|---|
Former Name | MELISSA APRIL MCKEON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2251X0800X Physical Therapist, Orthopedic (Licence: SC 6273) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: MA 19022) |
Enumeration Date | 2010-09-14 |
Last Update Date | 2015-10-20 |