| NPI | 1538567052 |
|---|---|
| Former Name | TIFFANY GRUBE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1282992) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WY 1554) |
| 225100000X Physical Therapist (Licence: NY 038572) | |
| Enumeration Date | 2014-12-16 |
| Last Update Date | 2016-10-19 |