| NPI | 1326539610 |
|---|---|
| Former Name | KELLY CLANCY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IN 05013647A) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: OH PT017430) |
| Enumeration Date | 2018-05-23 |
| Last Update Date | 2021-03-09 |