| NPI | 1568115640 |
|---|---|
| Former Name | ALYSSA LOGIE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 2251X0800X Physical Therapist, Orthopedic |
| Enumeration Date | 2022-01-30 |
| Last Update Date | 2024-12-16 |