NPI | 1649559444 |
---|---|
Former Name | LAURA DEIGHTON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: CO PTL.0011862) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: WY 1373) |
Enumeration Date | 2011-08-10 |
Last Update Date | 2017-12-20 |