| NPI | 1003934779 |
|---|---|
| Former Name | STACY M MITTON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: ME PT862) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NH 1777) |
| Enumeration Date | 2007-03-27 |
| Last Update Date | 2007-07-08 |