NPI | 1790806156 |
---|---|
Former Name | DAWN MARIE KISSMAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1296763) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: MO 2007018567) |
225100000X Physical Therapist (Licence: KS 11-03614) | |
Enumeration Date | 2007-04-03 |
Last Update Date | 2023-11-08 |