| NPI | 1760732622 |
|---|---|
| Former Name | AMANDA CATHERINE GILLMAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WA PT60447797) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: OR 6850) |
| Enumeration Date | 2012-09-18 |
| Last Update Date | 2014-12-18 |