| NPI | 1174104210 |
|---|---|
| Former Name | WHITNEY BURRIS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OK 5997) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: OK 2616) |
| Enumeration Date | 2021-04-20 |
| Last Update Date | 2021-06-01 |