| NPI | 1629043898 |
|---|---|
| Former Name | TIFFANY FITCH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: SC 4912) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NC 10097) |
| Enumeration Date | 2006-02-21 |
| Last Update Date | 2012-01-04 |