| NPI | 1841490091 |
|---|---|
| Former Name | MELISIA ANN BRENNAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: SC 12164) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NC P20743) |
| 225100000X Physical Therapist (Licence: TN 8548) | |
| Enumeration Date | 2007-07-24 |
| Last Update Date | 2024-01-05 |