NPI | 1881995587 |
---|---|
Former Name | BONNIE JO LUTZ |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: UT 12896081-2401) |
Additional Taxonomies | 2251P0200X Physical Therapist, Pediatrics (Licence: CA 37267) |
Enumeration Date | 2010-11-11 |
Last Update Date | 2022-12-16 |