| NPI | 1205363645 |
|---|---|
| Former Name | KELLY VOSBURGH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251N0400X Physical Therapist Neurology (Licence: MN 11323) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: PA PT024496) |
| 2251N0400X Physical Therapist Neurology (Licence: PA PT025596) | |
| Enumeration Date | 2017-05-16 |
| Last Update Date | 2019-02-11 |