NPI | 1962878397 |
---|---|
Former Name | KATHLEEN PORTER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 225100000X Physical Therapist (Licence: CO PTL.0011879) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: WY PT 1454) |
Enumeration Date | 2015-08-20 |
Last Update Date | 2015-08-20 |