| NPI | 1326441940 |
|---|---|
| Former Name | KIMBERLEE JANETTE DESPAIN ODLAUG |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics (Licence: AZ LPT-30638) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WA PT60439302) |
| 2251P0200X Physical Therapist, Pediatrics (Licence: WA PT60439302) | |
| Enumeration Date | 2014-09-28 |
| Last Update Date | 2019-04-29 |