NPI | 1720238553 |
---|---|
Former Name | MELLONY JUNE MEISTER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: KS 11-04815) |
Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: MO 2008028214) |
Enumeration Date | 2008-09-29 |
Last Update Date | 2018-08-15 |