NPI | 1568952604 |
---|---|
Former Name | NICOLE C MATZKE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: WI 14210-24) |
Additional Taxonomies | 225100000X Physical Therapist |
Enumeration Date | 2018-05-15 |
Last Update Date | 2020-09-22 |