NPI | 1679088520 |
---|---|
Former Name | AMANDA E PETERS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: IL 070024687) |
Additional Taxonomies | 225100000X Physical Therapist |
Enumeration Date | 2017-12-13 |
Last Update Date | 2021-03-09 |