NPI | 1831341841 |
---|---|
Former Name | RANDI LEIGH DAVIS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: SC 7528) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: FL PT 24367) |
Enumeration Date | 2008-10-21 |
Last Update Date | 2018-04-09 |