NPI | 1679150593 |
---|---|
Former Name | PEYTON ANNE REISCH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305214147) |
Additional Taxonomies | 2251X0800X Physical Therapist, Orthopedic (Licence: VA 2305214147) |
Enumeration Date | 2021-03-26 |
Last Update Date | 2024-09-06 |