| NPI | 1023367265 |
|---|---|
| Former Name | KRISTEN L SODERBECK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CO 0012741) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: ND 0916) |
| Enumeration Date | 2012-09-04 |
| Last Update Date | 2014-07-29 |