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 |