NPI | 1891007563 |
---|---|
Former Name | AMANDA TREINEN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: NE 2897) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: IA 004635) |
Enumeration Date | 2010-07-09 |
Last Update Date | 2015-05-30 |