NPI | 1669727962 |
---|---|
Former Name | MEREDITH MARIE BRUNETTE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2251X0800X Physical Therapist, Orthopedic (Licence: TX 1220500) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: TX 1220500) |
225100000X Physical Therapist (Licence: OR 06844) | |
Enumeration Date | 2012-07-23 |
Last Update Date | 2015-05-15 |