| NPI | 1144262619 |
|---|---|
| Former Name | NICOLE KELLEY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: NH 722) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist Athletic Trainer (Licence: NH 0147) |
| Enumeration Date | 2006-06-11 |
| Last Update Date | 2009-11-24 |