| NPI | 1396220745 |
|---|---|
| Former Name | ALLYCIA CATHRYN SHACKELFORD |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OR 63647) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WA 60895521) |
| 225100000X Physical Therapist (Licence: CO 0014101) | |
| Enumeration Date | 2018-10-02 |
| Last Update Date | 2023-01-17 |