| NPI | 1528512084 |
|---|---|
| Former Name | KELLIE JONES |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics (Licence: CT 9688) |
| Additional Taxonomies | 2251P0200X Physical Therapist, Pediatrics (Licence: NY 035248-1) |
| Enumeration Date | 2016-08-12 |
| Last Update Date | 2017-04-28 |