NPI | 1619390812 |
---|---|
Former Name | ABBEY MARIE PAISLEY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: OH AT.004906) |
Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: NC 1942) |
Enumeration Date | 2014-01-24 |
Last Update Date | 2016-11-28 |