| NPI | 1104941673 |
|---|---|
| Former Name | STACY MICHELLE WHEELER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MO 2017042705) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: AR 2644) |
| Enumeration Date | 2007-03-20 |
| Last Update Date | 2022-07-14 |