NPI | 1730205204 |
---|---|
Former Name | SHELLY EDWARDS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: WA PT00009283) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: CA PT25490) |
Enumeration Date | 2007-03-22 |
Last Update Date | 2012-09-07 |