| NPI | 1972909091 |
|---|---|
| Former Name | TRICIA VANSELOW |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: ND 1805) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MN 9792) |
| Enumeration Date | 2014-11-17 |
| Last Update Date | 2021-08-23 |