NPI | 1710950563 |
---|---|
Former Name | CARRIE ANN FRIEDRICH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: IN 05010309A) |
Additional Taxonomies | 2251X0800X Physical Therapist Orthopedic (Licence: IN 05010309A) |
2255A2300X Specialist/Technologist Athletic Trainer (Licence: IN 36001017A) | |
Enumeration Date | 2006-02-10 |
Last Update Date | 2022-12-05 |