| NPI | 1588535363 |
|---|---|
| Former Name | D MYCHELE GEORGE |
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: CO 0015689) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: TX 2050290) |
| Enumeration Date | 2025-09-15 |
| Last Update Date | 2025-09-16 |