NPI | 1831175710 |
---|---|
Former Name | ALISON MARIE DEICHERT |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: MO 2011000805) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: KS 11-03349) |
Enumeration Date | 2005-12-21 |
Last Update Date | 2018-03-16 |