NPI | 1629214531 |
---|---|
Former Name | MELISSA R LACHANCE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: GA PT010748) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: RI PT02197) |
225100000X Physical Therapist (Licence: MA 18512) | |
Enumeration Date | 2008-12-23 |
Last Update Date | 2020-08-03 |