| NPI | 1639593783 |
|---|---|
| Former Name | LAUREN WETTACH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: GA PT016274) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IA 005302) |
| 225100000X Physical Therapist (Licence: WI 12950-24) | |
| Enumeration Date | 2014-02-10 |
| Last Update Date | 2023-11-23 |