| NPI | 1992029649 |
|---|---|
| Former Name | MARY JANAE DEATS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NC P12533) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: PA PT020999) |
| Enumeration Date | 2010-03-24 |
| Last Update Date | 2022-09-22 |