| NPI | 1942601232 |
|---|---|
| Former Name | BRENDA WAMPLER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: ID PT-3207) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WY PT-1500) |
| Enumeration Date | 2014-09-06 |
| Last Update Date | 2014-09-06 |