| NPI | 1376820662 |
|---|---|
| Former Name | MANDI ELISE FETTERS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OH PT.013298) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CA 38346) |
| Enumeration Date | 2011-11-15 |
| Last Update Date | 2023-11-27 |