| NPI | 1376814509 |
|---|---|
| Former Name | KELLY B CAMPBELL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: RI PT02365) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 012882) |
| Enumeration Date | 2012-01-19 |
| Last Update Date | 2012-01-19 |