NPI | 1740424191 |
---|---|
Former Name | ASHLEY DEBOISE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305208934) |
Additional Taxonomies | 2251S0007X Physical Therapist, Sports (Licence: TX 1162191) |
2251X0800X Physical Therapist, Orthopedic (Licence: TX 1162191) | |
Enumeration Date | 2009-04-29 |
Last Update Date | 2021-08-24 |