NPI | 1730808494 |
---|---|
Former Name | SHELBY L TIPTON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1367761) |
Additional Taxonomies | 2251P0200X Physical Therapist Pediatrics (Licence: TX 1367761) |
Enumeration Date | 2022-08-25 |
Last Update Date | 2024-02-09 |