NPI | 1639622582 |
---|---|
Former Name | SAMANTHA L. BRUGGEMAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: WV 004094) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: VA 2305210468) |
Enumeration Date | 2016-07-27 |
Last Update Date | 2019-04-09 |