| NPI | 1760862585 |
|---|---|
| Former Name | TIFFANY BRADFORD |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: UT 12347162-2401) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL PT 30377) |
| Enumeration Date | 2015-06-06 |
| Last Update Date | 2024-09-26 |