| NPI | 1982009536 |
|---|---|
| Former Name | BEVERLY ANN WEITHMAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CA 41812) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: KS 11-07083) |
| 225100000X Physical Therapist (Licence: MO 2022028779) | |
| Enumeration Date | 2014-10-24 |
| Last Update Date | 2024-02-18 |