| NPI | 1356619795 |
|---|---|
| Former Name | BAILEY ELLISON MASON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 261QP2000X Clinic/Center, Physical Therapy (Licence: OR 6729) |
| Enumeration Date | 2011-12-13 |
| Last Update Date | 2020-06-10 |