NPI | 1811238645 |
---|---|
Former Name | ANGELICA ELIZABETH FLYNN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 225100000X Physical Therapist (Licence: WA PT60329481) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: AZ 10804) |
Enumeration Date | 2013-03-04 |
Last Update Date | 2016-06-14 |