NPI | 1285142497 |
---|---|
Former Name | KELSEY RAE LAFOND |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: ND 2580) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: AZ 13289) |
Enumeration Date | 2018-01-22 |
Last Update Date | 2022-01-29 |