| NPI | 1427273127 |
|---|---|
| Former Name | SHELLY ANN RIKANSRUD |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: TN PTA3453) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: TX 2060707) |
| 225200000X Physical Therapy Assistant (Licence: WY PTA555) | |
| 225200000X Physical Therapy Assistant (Licence: FL PTA1511) | |
| 225200000X Physical Therapy Assistant (Licence: GA PTA2216) | |
| Enumeration Date | 2007-04-16 |
| Last Update Date | 2007-07-08 |