NPI | 1982139648 |
---|---|
Former Name | ANN MARIE MULLEN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 225700000X Massage Therapist (Licence: OR 17700) |
Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: OR 09411) |
Enumeration Date | 2017-05-01 |
Last Update Date | 2023-11-29 |