| NPI | 1497991368 |
|---|---|
| Former Name | KRISTIN MICHELLE MCCORKLE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NJ 40QA001455400) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 029675-1) |
| Enumeration Date | 2008-12-26 |
| Last Update Date | 2018-04-12 |