NPI | 1316529217 |
---|---|
Former Name | CAYLEE ANN KOKER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 225100000X Physical Therapist (Licence: WI 16486) |
Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer |
Enumeration Date | 2021-04-21 |
Last Update Date | 2024-12-04 |