| NPI | 1093229023 |
|---|---|
| Former Name | KYLEE BLAKE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: AL PTH8786) |
| Additional Taxonomies | 225100000X Physical Therapist |
| Enumeration Date | 2017-11-29 |
| Last Update Date | 2021-12-08 |