NPI | 1497257232 |
---|---|
Former Name | ALEXANDRA LEE KELLY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: FL PT35883) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: MI 5501018579) |
Enumeration Date | 2018-03-07 |
Last Update Date | 2025-04-16 |