NPI | 1992840359 |
---|---|
Former Name | JANE MCKEON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: MA 45) |
Additional Taxonomies | 225700000X Massage Therapist (Licence: MA 1806) |
Enumeration Date | 2007-02-21 |
Last Update Date | 2008-05-25 |