| NPI | 1659486256 |
|---|---|
| Former Name | JULIE LYNN THIESZEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174400000X Specialist (Licence: UT 344119-2401) |
| Additional Taxonomies | 2251X0800X Physical Therapist, Orthopedic |
| Enumeration Date | 2006-08-21 |
| Last Update Date | 2019-01-11 |