| NPI | 1588982375 |
|---|---|
| Former Name | CORTNEY RENAE JOHN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IA 02953) |
| Additional Taxonomies | 2251S0007X Physical Therapist, Sports (Licence: IA 02953) |
| Enumeration Date | 2010-05-04 |
| Last Update Date | 2022-11-16 |