| NPI | 1053877001 |
|---|---|
| Former Name | KIRA SADE SCOTT |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TN 12617) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MS PT6618) |
| Enumeration Date | 2019-02-14 |
| Last Update Date | 2021-05-27 |