| NPI | 1326439373 |
|---|---|
| Former Name | MELISSA HUMPHRES |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WI 14022) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TN 9667) |
| Enumeration Date | 2015-02-12 |
| Last Update Date | 2019-10-01 |