| NPI | 1255605093 |
|---|---|
| Former Name | PAIGE CARISSA CHENOWETH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL 29954) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CA PT 38588) |
| 225100000X Physical Therapist (Licence: MO 2017018683) | |
| Enumeration Date | 2012-02-24 |
| Last Update Date | 2022-07-21 |