| NPI | 1811443518 |
|---|---|
| Other Name | MICHAEL DEAN VAN TRUMP |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: AR PTA 2390) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: MO 2007019796) |
| Enumeration Date | 2016-09-01 |
| Last Update Date | 2016-09-01 |