| NPI | 1588211569 |
|---|---|
| Former Name | THERESA WALTON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: IA 073794) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: WI 2237) |
| Enumeration Date | 2019-08-23 |
| Last Update Date | 2024-02-22 |