| NPI | 1447685946 |
|---|---|
| Former Name | KELSEA ROSE LUNDQUIST |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MD 26915) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CA 35901) |
| 225100000X Physical Therapist (Licence: NC 14277) | |
| Enumeration Date | 2013-09-04 |
| Last Update Date | 2018-03-28 |