| NPI | 1184171696 |
|---|---|
| Former Name | KELSEY RAE GEORGE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IL 070.022615) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WI 13535-24) |
| Enumeration Date | 2016-09-01 |
| Last Update Date | 2022-05-17 |