| NPI | 1558606764 |
|---|---|
| Former Name | SHANYN D FIALKOV |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CO PTL0013752) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MA 20186) |
| Enumeration Date | 2012-11-29 |
| Last Update Date | 2022-07-21 |