NPI | 1639501653 |
---|---|
Former Name | LEAH MICHELLE CAMPBELL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: GA PT011083) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: SC 9029) |
Enumeration Date | 2013-08-01 |
Last Update Date | 2018-03-17 |