| NPI | 1710431523 |
|---|---|
| Former Name | HEATHER BODIN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MN 11795) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: OR 61897) |
| Enumeration Date | 2016-08-09 |
| Last Update Date | 2020-05-17 |