NPI | 1962028191 |
---|---|
Former Name | MELINDA DUCKETT |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 225100000X Physical Therapist (Licence: CA PT306187) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: AK PHYP1144) |
Enumeration Date | 2020-06-23 |
Last Update Date | 2025-03-05 |