| NPI | 1477806230 |
|---|---|
| Former Name | ADRIENNE LEE BALOS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL 27845) |
| Additional Taxonomies | 2251P0200X Physical Therapist, Pediatrics (Licence: GA PT010912) |
| Enumeration Date | 2012-10-18 |
| Last Update Date | 2021-10-05 |