| NPI | 1770851370 |
|---|---|
| Former Name | LAURA L CHERCHUCK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OR 60407) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: PA PT021614) |
| Enumeration Date | 2011-12-09 |
| Last Update Date | 2015-08-19 |