NPI | 1902307929 |
---|---|
Former Name | LAURA SUCHOCKI |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 225100000X Physical Therapist (Licence: CO PTL.0015169) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: NC P17657) |
225100000X Physical Therapist (Licence: WA PT60996989) | |
Enumeration Date | 2018-02-25 |
Last Update Date | 2024-04-24 |