NPI | 1699095000 |
---|---|
Former Name | BETH ANN MILLAGE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: MN 8303) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: ND 1318) |
225100000X Physical Therapist (Licence: AZ 6259) | |
Enumeration Date | 2010-06-08 |
Last Update Date | 2020-04-07 |