| NPI | 1063811552 |
|---|---|
| Former Name | ALISSE INDRELIE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251X0800X Physical Therapist, Orthopedic (Licence: MN 9689) |
| Additional Taxonomies | 2251G0304X Physical Therapist, Geriatrics (Licence: MN 9689) |
| Enumeration Date | 2014-08-20 |
| Last Update Date | 2020-03-31 |