| NPI | 1275092579 |
|---|---|
| Former Name | STEPHANIE DEVANE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305212650) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NC P18539) |
| Enumeration Date | 2019-03-16 |
| Last Update Date | 2023-12-19 |