| NPI | 1225552664 |
|---|---|
| Former Name | BROGAN UPHOFF |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: KY 007181) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MO 2021048123) |
| Enumeration Date | 2017-07-27 |
| Last Update Date | 2021-12-02 |