NPI | 1871540179 |
---|---|
Former Name | ERICA LYNNE STUCKEY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: PA PT018049) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: OH PT013059) |
Enumeration Date | 2006-05-30 |
Last Update Date | 2023-08-03 |