| NPI | 1093720906 |
|---|---|
| Former Name | ALEXIS MICHELLE WHITAKER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: SC 4446) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TN 9925) |
| Enumeration Date | 2006-07-29 |
| Last Update Date | 2015-11-09 |