NPI | 1699147728 |
---|---|
Former Name | KATIE JO REDMOND |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: NH 2814) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: MA 15808) |
Enumeration Date | 2015-10-28 |
Last Update Date | 2015-10-28 |