| NPI | 1427313683 |
|---|---|
| Former Name | KRISTEN ANN FONTANELLA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CT 009456) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NC P14025) |
| Enumeration Date | 2012-07-12 |
| Last Update Date | 2016-03-08 |