| NPI | 1588986194 |
|---|---|
| Other Name | DBA: BAYSPORT THERAPY SERVICES |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CA PT34647) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CA 26599) |
| Enumeration Date | 2010-02-23 |
| Last Update Date | 2010-02-23 |