| NPI | 1487688354 |
|---|---|
| Former Name | JOLYNN OHLDE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: KS 14-0550) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: MO 2002009370) |
| 2255A2300X Specialist/Technologist Athletic Trainer (Licence: KS 24-00448) | |
| 2255A2300X Specialist/Technologist Athletic Trainer (Licence: MO 2005017782) | |
| Enumeration Date | 2006-07-10 |
| Last Update Date | 2010-01-29 |