NPI | 1558781872 |
---|---|
Former Name | ALISON MARIE BROUILLETTE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: WA PT60878849) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: MA 20613) |
Enumeration Date | 2014-04-25 |
Last Update Date | 2021-03-30 |