NPI | 1871250936 |
---|---|
Former Name | MICHELLE RITLEY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MD C0008180) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: MD 20552) |
225100000X Physical Therapist (Licence: OH PT009536) | |
Enumeration Date | 2021-11-23 |
Last Update Date | 2021-11-23 |