| NPI | 1104473529 |
|---|---|
| Former Name | KELSEA SANFORD |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: AR PT5472) |
| Additional Taxonomies | 225100000X Physical Therapist |
| Enumeration Date | 2019-08-20 |
| Last Update Date | 2025-06-11 |