| NPI | 1457655235 |
|---|---|
| Former Name | KATRINA SUE WENGER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: PA PT009626L) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: PA DAPT001661) |
| 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: PA RT001500A) | |
| Enumeration Date | 2011-01-07 |
| Last Update Date | 2020-05-11 |