NPI | 1619420015 |
---|---|
Former Name | ALYSSA R MILLER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: NC CP-CP027853T) |
Additional Taxonomies | 2251P0200X Physical Therapist, Pediatrics (Licence: CO PTL.0014261) |
Enumeration Date | 2016-08-02 |
Last Update Date | 2024-03-11 |