NPI | 1477851814 |
---|---|
Former Name | KATRINA JOANN STONEBACK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: OR 61113) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: CA 37164) |
2251X0800X Physical Therapist, Orthopedic (Licence: CA 37164) | |
Enumeration Date | 2011-03-09 |
Last Update Date | 2018-03-17 |