| NPI | 1588621569 |
|---|---|
| Former Name | TASHA ALICE BOOCK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: IA 001444) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: IA 754YY8930) |
| Enumeration Date | 2006-04-26 |
| Last Update Date | 2010-08-13 |