NPI | 1720359896 |
---|---|
Former Name | RACHEL L. RETALLICK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: VA 0102203605) |
Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: PA OS020867) |
Enumeration Date | 2012-01-22 |
Last Update Date | 2024-12-03 |