| NPI | 1043983901 |
|---|---|
| Former Name | ELYSSA G DEVRIES |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: FL 31181) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant |
| Enumeration Date | 2021-07-27 |
| Last Update Date | 2021-07-27 |