NPI | 1679828982 |
---|---|
Former Name | MELISSA CZAJKA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305210974) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 035252) |
225100000X Physical Therapist (Licence: DC 871655) | |
Enumeration Date | 2012-07-24 |
Last Update Date | 2018-01-18 |