NPI | 1750621660 |
---|---|
Former Name | MOLLY DEWEY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: CO PTA.0012706) |
Additional Taxonomies | 225700000X Massage Therapist (Licence: CO MT.0012105) |
Enumeration Date | 2013-03-01 |
Last Update Date | 2013-03-01 |