| NPI | 1235507336 |
|---|---|
| Former Name | KRYSTEL M NOLA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL PT 30606) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IL 070021837) |
| Enumeration Date | 2015-09-04 |
| Last Update Date | 2020-06-03 |