| NPI | 1275708273 |
|---|---|
| Former Name | VICKIE HELEN KELLY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NC P10504) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NC 10504) |
| Enumeration Date | 2008-04-30 |
| Last Update Date | 2021-02-24 |