| NPI | 1346384823 |
|---|---|
| Former Name | MICAH LEA WOLF |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MO 2006034641) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: KS 11-04726) |
| Enumeration Date | 2007-02-16 |
| Last Update Date | 2018-05-08 |