NPI | 1205896677 |
---|---|
Former Name | KRISTEN KANTNER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: FL 11629) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: GA 3079) |
225100000X Physical Therapist (Licence: NC 4250) | |
Enumeration Date | 2006-03-28 |
Last Update Date | 2009-10-20 |