| NPI | 1225284128 |
|---|---|
| Former Name | KIMBERLY MARIE FOWLER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WI 11029-024) |
| Additional Taxonomies | 225100000X Physical Therapist |
| Enumeration Date | 2008-08-11 |
| Last Update Date | 2009-12-16 |