| NPI | 1558986117 |
|---|---|
| Former Name | MARIANNE INGERSOLL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: PA PT028599) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: PT-6939) |
| Enumeration Date | 2020-06-10 |
| Last Update Date | 2023-07-18 |