NPI | 1235351586 |
---|---|
Former Name | KELLY DENISE WOODS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: CA PT 27167) |
Additional Taxonomies | 2251S0007X Physical Therapist, Sports |
Enumeration Date | 2007-05-03 |
Last Update Date | 2017-01-13 |