NPI | 1538659776 |
---|---|
Former Name | AMANDA JO KELLERMAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 111N00000X Chiropractor (Licence: IN 08003133A) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: OH DC-04818) |
Enumeration Date | 2018-05-14 |
Last Update Date | 2020-02-10 |