| NPI | 1467803304 |
|---|---|
| Former Name | BRIANNE DAVIS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MO 2016020972) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: KS 11-05321) |
| Enumeration Date | 2016-06-22 |
| Last Update Date | 2016-06-22 |