NPI | 1982131066 |
---|---|
Former Name | MORGAN LEE MADDOX |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: KS 11-05628) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: MO 2017030848) |
Enumeration Date | 2017-05-19 |
Last Update Date | 2020-04-15 |