NPI | 1649785700 |
---|---|
Former Name | CASEY M WOLFE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: IL 070023493) |
Additional Taxonomies | 225100000X Physical Therapist |
Enumeration Date | 2017-12-11 |
Last Update Date | 2020-02-12 |