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Individual
ABBY RAE REZANSOFF
Active
Individual
ABBY RAE REZANSOFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
082377
IA
225100000X
Physical Therapist
PT4260
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1508265091
—
IA
Enumeration date
08/20/2014
Last updated
05/04/2017
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