| NPI | 1093895880 |
|---|---|
| Former Name | MANDA LINEA KELLER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MN 8928) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WI 10691) |
| Enumeration Date | 2006-10-16 |
| Last Update Date | 2013-11-22 |