| NPI | 1174994057 |
|---|---|
| Former Name | CASEY DONAHUE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: AR 2174) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: TX 2103059) |
| Enumeration Date | 2015-10-17 |
| Last Update Date | 2018-03-17 |