NPI | 1801214036 |
---|---|
Former Name | MEGAN JURKOWSKI |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305208568) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: CT 8623) |
Enumeration Date | 2014-04-04 |
Last Update Date | 2014-04-04 |