| NPI | 1972610251 |
|---|---|
| Former Name | CHERYL LEE FORT |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WA PT60019567) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: OR 2579) |
| Enumeration Date | 2006-08-24 |
| Last Update Date | 2021-12-21 |