NPI | 1255386165 |
---|---|
Former Name | STACEY L PALMER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: KS 11-03366) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: MO 110767) |
Enumeration Date | 2006-05-23 |
Last Update Date | 2014-02-11 |