NPI | 1255098810 |
---|---|
Former Name | KAY RUTH BELLVILLE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: UT 049602402) |
Enumeration Date | 2021-11-18 |
Last Update Date | 2021-11-18 |