NPI | 1053606657 |
---|---|
Former Name | KALA PLANTZ |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: IA 077175) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: WI 11819-24) |
Enumeration Date | 2011-06-13 |
Last Update Date | 2015-04-07 |