| NPI | 1366882672 |
|---|---|
| Former Name | MCKENZI R VANFOSSEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NM 5149) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: OH PT014260) |
| Enumeration Date | 2013-07-01 |
| Last Update Date | 2018-03-17 |