| NPI | 1265848113 |
|---|---|
| Former Name | KATELYN BROOKS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: CO 050708072) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: CO 0013188) |
| Enumeration Date | 2014-07-10 |
| Last Update Date | 2014-07-10 |