NPI | 1972815744 |
---|---|
Former Name | REBECCA SUE EVERSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: MO 2012008848) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: GA PT009967) |
Enumeration Date | 2010-07-09 |
Last Update Date | 2015-03-12 |