| NPI | 1265720239 |
|---|---|
| Former Name | STACY ANN ALLEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MD 23721) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: PA PT021003) |
| 225100000X Physical Therapist (Licence: AZ 10957) | |
| Enumeration Date | 2011-07-12 |
| Last Update Date | 2015-02-05 |