| NPI | 1942283577 |
|---|---|
| Former Name | JUDITH SUSAN WHEALAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MA 11089) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: MA 1232) |
| Enumeration Date | 2005-11-29 |
| Last Update Date | 2008-07-22 |