| NPI | 1083646061 |
|---|---|
| Former Name | KELLY ANN DEMELLE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WI 10212024) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IL 070014256) |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2021-12-08 |