NPI | 1801860556 |
---|---|
Former Name | AMY JO CHURCHILL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: VA 0126000278) |
Enumeration Date | 2006-02-16 |
Last Update Date | 2007-07-08 |