| NPI | 1508262015 |
|---|---|
| Former Name | MARIAH DIANE EKART |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OR 65241) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer |
| 225100000X Physical Therapist (Licence: KS 11-06031) | |
| Enumeration Date | 2014-11-11 |
| Last Update Date | 2024-05-20 |