| NPI | 1033737788 |
|---|---|
| Former Name | CLARA JORDAN PHILLIPS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: KS 11-06506) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: ID 6698) |
| Enumeration Date | 2020-07-09 |
| Last Update Date | 2020-07-15 |