NPI | 1790844801 |
---|---|
Former Name | CHRISTA JOY HICKS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: NC 10816) |
Additional Taxonomies | 2251N0400X Physical Therapist, Neurology (Licence: NC 10816) |
Enumeration Date | 2006-12-06 |
Last Update Date | 2011-01-14 |