NPI | 1992078323 |
---|---|
Former Name | AMY M WEDEKING |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: IA 086054) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: MO 2012005137) |
Enumeration Date | 2012-02-15 |
Last Update Date | 2017-02-08 |