NPI | 1902326606 |
---|---|
Former Name | LAUREN BOYLER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: MN 10725) |
Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: MN 2949) |
2255A2300X Specialist/Technologist, Athletic Trainer (Licence: WI 897-039) | |
Enumeration Date | 2017-06-23 |
Last Update Date | 2022-07-21 |