| NPI | 1962871947 |
|---|---|
| Former Name | COLLEEN MARIE VIERK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MT 21680) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CO PTL.0013870) |
| 225100000X Physical Therapist (Licence: MI 5501017432) | |
| Enumeration Date | 2015-09-19 |
| Last Update Date | 2022-09-06 |