| NPI | 1043994569 |
|---|---|
| Former Name | KRISTEN LEE MACKIE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WA PT61443440) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TN 16329) |
| Enumeration Date | 2023-06-14 |
| Last Update Date | 2025-02-28 |