| NPI | 1497122816 |
|---|---|
| Former Name | CARLY JEAN RUSCHEINSKY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: ND 2278) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist Athletic Trainer |
| Enumeration Date | 2015-09-02 |
| Last Update Date | 2020-10-02 |