| NPI | 1518921154 |
|---|---|
| Former Name | STACIE C. VISSER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: WA P160045502) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer |
| 225200000X Physical Therapy Assistant (Licence: ID PTA-2497) | |
| Enumeration Date | 2006-04-12 |
| Last Update Date | 2014-04-29 |