| NPI | 1730646332 |
|---|---|
| Former Name | PAIGE E LINCICUM |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WI 15411-24) |
| Additional Taxonomies | 225100000X Physical Therapist |
| Enumeration Date | 2019-03-01 |
| Last Update Date | 2021-11-17 |