| NPI | 1932244258 |
|---|---|
| Former Name | MARTHA HANNAH BAGWELL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: SC 1048) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant |
| Enumeration Date | 2007-02-21 |
| Last Update Date | 2013-05-13 |