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Individual
MS. MAURA ELAINE DESHAW
Active
Individual
MS. MAURA ELAINE DESHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
1770
MT
225100000X
Physical Therapist
2536
NE
363A00000X
Physician Assistant
1275
NE
363A00000X
Physician Assistant
Primary
568
MT
Other
Enumeration date
04/13/2007
Last updated
11/21/2009
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