| NPI | 1871665729 |
|---|---|
| Former Name | TERI CHARLTON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MI 5001006630) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MI 5501006630) |
| Enumeration Date | 2006-11-15 |
| Last Update Date | 2018-07-24 |