| NPI | 1588494496 |
|---|---|
| Former Name | JOSHUA MICHAEL MENKE |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: IA 126983) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: MN A2062) |
| Enumeration Date | 2024-08-05 |
| Last Update Date | 2024-08-05 |