| NPI | 1700498706 |
|---|---|
| Former Name | LAUREN DEGROAT |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305213959) |
| Additional Taxonomies | 225100000X Physical Therapist |
| Enumeration Date | 2020-08-20 |
| Last Update Date | 2022-11-16 |