| NPI | 1326393562 |
|---|---|
| Former Name | ERIN NICHOLE ELLISON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: KS 11-04445) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: KS T03325) |
| Enumeration Date | 2012-07-13 |
| Last Update Date | 2013-01-16 |