| NPI | 1558730655 |
|---|---|
| Former Name | KRISTEN MARY TARANTO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: AZ LPT30388) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TN 10971) |
| 2255A2300X Specialist/Technologist Athletic Trainer (Licence: FL AL3752) | |
| Enumeration Date | 2015-09-18 |
| Last Update Date | 2019-01-16 |