NPI | 1578701637 |
---|---|
Former Name | BETH E HENRICKS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 225100000X Physical Therapist (Licence: MI 550102963) |
Additional Taxonomies | 261QP2000X Clinic/Center, Physical Therapy (Licence: MI 5501012963) |
Enumeration Date | 2009-01-28 |
Last Update Date | 2024-11-21 |