| NPI | 1780817148 |
|---|---|
| Former Name | MARY LIBBY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: SC 10091) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL PT14465) |
| Enumeration Date | 2009-09-01 |
| Last Update Date | 2020-04-09 |