| NPI | 1184237208 |
|---|---|
| Former Name | KAITLYN MARIE DVORAK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IL 070-026319) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NM PT5769) |
| 225100000X Physical Therapist (Licence: IA 122211) | |
| Enumeration Date | 2020-08-28 |
| Last Update Date | 2024-09-27 |