NPI | 1649555798 |
---|---|
Former Name | AMANDA M HANSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2251X0800X Physical Therapist, Orthopedic |
Additional Taxonomies | 2251S0007X Physical Therapist, Sports |
Enumeration Date | 2011-10-19 |
Last Update Date | 2018-09-26 |