NPI | 1700415205 |
---|---|
Former Name | MARCELLA EUBANKS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: NC A5071) |
Additional Taxonomies | 225700000X Massage Therapist (Licence: NC 11301) |
Enumeration Date | 2020-04-06 |
Last Update Date | 2025-10-16 |