| NPI | 1356491062 |
|---|---|
| Former Name | LAUREL ANN MCKINNY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NE 3486) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IN 05007727A) |
| Enumeration Date | 2007-01-12 |
| Last Update Date | 2015-07-23 |