NPI | 1548800931 |
---|---|
Former Name | LEXIE L MOMBERGER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: CA 301017) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: FL PT33880) |
225100000X Physical Therapist (Licence: TX 1332541) | |
Enumeration Date | 2020-01-14 |
Last Update Date | 2021-11-02 |