| NPI | 1598991879 |
|---|---|
| Former Name | TERESA EWING |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IL 070-005449) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WI 2515-024) |
| Enumeration Date | 2009-06-01 |
| Last Update Date | 2016-04-21 |