| NPI | 1275780959 |
|---|---|
| Former Name | KIMBERLY RENEE' PHELPS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: VA 0104001037) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: MO 005734) |
| Enumeration Date | 2008-08-25 |
| Last Update Date | 2009-02-13 |