NPI | 1992296941 |
---|---|
Former Name | DEVAN MYRINDA COLEMAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: KS 11-05902) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: MO 2018023462) |
Enumeration Date | 2018-05-25 |
Last Update Date | 2020-11-30 |