| NPI | 1760096077 |
|---|---|
| Former Name | TAYLOR L WISKUS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IA 099278) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IL 70025037) |
| Enumeration Date | 2020-09-03 |
| Last Update Date | 2023-07-07 |