| NPI | 1851714505 |
|---|---|
| Former Name | LAURA WICK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CO 19712) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TX 1288773) |
| Enumeration Date | 2014-01-31 |
| Last Update Date | 2024-03-13 |