| NPI | 1750780185 |
|---|---|
| Former Name | LEAH PETERSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: ND 2151) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MN 10579) |
| 225100000X Physical Therapist (Licence: CO PTH0012881) | |
| Enumeration Date | 2014-08-21 |
| Last Update Date | 2018-12-28 |