| NPI | 1154734176 |
|---|---|
| Former Name | KAITLYN E CHILDERS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: AZ LPT-32329) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: OR 63178) |
| 225100000X Physical Therapist (Licence: WI 12734-24) | |
| Enumeration Date | 2014-06-06 |
| Last Update Date | 2022-11-30 |