NPI | 1477958205 |
---|---|
Former Name | KJERSTIN SCHILLO |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305213386) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: ME PT4386) |
225100000X Physical Therapist (Licence: NH 3939) | |
Enumeration Date | 2014-10-22 |
Last Update Date | 2020-02-03 |