| NPI | 1205007705 |
|---|---|
| Former Name | KRYSTAL DAWN SMITH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251X0800X Physical Therapist, Orthopedic (Licence: GA PT009036) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: GA PT009035) |
| Enumeration Date | 2008-03-12 |
| Last Update Date | 2017-11-21 |