NPI | 1336330315 |
---|---|
Former Name | ASHLEY AMBER KIERSTED |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 225100000X Physical Therapist (Licence: CA 41300) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: MA 18011) |
Enumeration Date | 2007-08-06 |
Last Update Date | 2014-08-14 |