| NPI | 1558989178 |
|---|---|
| Former Name | ALICIA MICHELLE CAMPBELL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1330699) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MO 2019029996) |
| Enumeration Date | 2020-07-09 |
| Last Update Date | 2020-07-09 |