| NPI | 1831523778 |
|---|---|
| Former Name | COURTNEY SUE TAGGART |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: PA PT022828) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NC 14539) |
| Enumeration Date | 2013-08-28 |
| Last Update Date | 2015-10-28 |