| NPI | 1164007779 |
|---|---|
| Former Name | KATIE SMALLIDGE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305214506) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NC P20113) |
| Enumeration Date | 2021-03-15 |
| Last Update Date | 2023-08-15 |