| NPI | 1871257568 |
|---|---|
| Former Name | LAUREN RIDDELL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TN 13651) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: GA CP008201T) |
| Enumeration Date | 2021-10-28 |
| Last Update Date | 2025-08-14 |