| NPI | 1891276663 |
|---|---|
| Former Name | CHEYENNE M HERTLEIN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: GA PT013919) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: ME PT4647) |
| Enumeration Date | 2018-08-28 |
| Last Update Date | 2020-07-06 |