| NPI | 1063962025 |
|---|---|
| Former Name | KIMBERLY ANN KEATHLEY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251X0800X Physical Therapist Orthopedic (Licence: CA PT292762) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant |
| Enumeration Date | 2016-10-13 |
| Last Update Date | 2022-10-05 |