NPI | 1700515160 |
---|---|
Former Name | LEIGH TAYLOR MOSS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: TN 14205) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: MS CP018460T) |
Enumeration Date | 2022-06-09 |
Last Update Date | 2024-08-30 |