| 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 |