| NPI | 1407436918 |
|---|---|
| Former Name | KATHERINE GRACE MENGES |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MO 2021028503) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: KS 11-06762) |
| Enumeration Date | 2021-04-09 |
| Last Update Date | 2021-10-12 |