| NPI | 1295149391 |
|---|---|
| Former Name | MARISSA MCNELLY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: CO POD.0000970) |
| Additional Taxonomies | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: IN 41000316A) |
| 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: WI 1099-25) | |
| Enumeration Date | 2014-06-17 |
| Last Update Date | 2026-01-06 |