NPI | 1104844430 |
---|---|
Former Name | KELLY J WOLF |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 111N00000X Chiropractor (Licence: WI 3919) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: WI 3919-012) |
Enumeration Date | 2006-07-17 |
Last Update Date | 2023-08-22 |