NPI | 1962827337 |
---|---|
Former Name | SHANNON DEFILIPPO |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: PA PT024790) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: PA DAPT003449) |
225100000X Physical Therapist (Licence: CT 10056) | |
Enumeration Date | 2014-02-21 |
Last Update Date | 2024-01-17 |