NPI | 1740321637 |
---|---|
Former Name | TRACY L WILHELM |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: IL 070013704) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: TN 10054) |
225100000X Physical Therapist (Licence: MS 5623) | |
Enumeration Date | 2007-02-12 |
Last Update Date | 2017-02-03 |