NPI | 1548636533 |
---|---|
Former Name | BROOKE DOLBERG |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 225100000X Physical Therapist (Licence: AZ 11745) |
Additional Taxonomies | 2251S0007X Physical Therapist, Sports |
2251X0800X Physical Therapist, Orthopedic | |
Enumeration Date | 2015-08-13 |
Last Update Date | 2024-09-24 |