NPI | 1962620880 |
---|---|
Former Name | JOAN LINDA FEAD |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: NE 1280) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: CO 1380) |
225100000X Physical Therapist (Licence: CA PT 9436) | |
225100000X Physical Therapist (Licence: NY 7433) | |
Enumeration Date | 2007-04-23 |
Last Update Date | 2007-07-09 |