NPI | 1528584174 |
---|---|
Former Name | KELSEY JURIST |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: PA PT028488) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: NJ 40QA01749000) |
Enumeration Date | 2017-08-16 |
Last Update Date | 2021-04-23 |