| NPI | 1295352318 |
|---|---|
| Former Name | SAVANNA BROOKE WELLS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1362798) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: SC 10233) |
| Enumeration Date | 2020-07-06 |
| Last Update Date | 2022-07-05 |