| NPI | 1285498113 |
|---|---|
| Former Name | JULIE O'KEEFE WILSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1115657) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TX 11156547) |
| Enumeration Date | 2024-02-12 |
| Last Update Date | 2024-02-12 |