| NPI | 1467765131 |
|---|---|
| Former Name | KELLY MORAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 045067) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WA PT60159763) |
| Enumeration Date | 2010-07-22 |
| Last Update Date | 2019-12-06 |