NPI | 1851706675 |
---|---|
Former Name | KIMBERLY LUNDE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: MA 20957) |
Additional Taxonomies | 2251X0800X Physical Therapist Orthopedic (Licence: DC 871793) |
Enumeration Date | 2014-07-01 |
Last Update Date | 2023-12-20 |