NPI | 1508318973 |
---|---|
Former Name | SIERRA RAE KELTNER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: NC 16644) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: TX 1256179) |
Enumeration Date | 2016-11-01 |
Last Update Date | 2024-11-14 |