| NPI | 1568783892 |
|---|---|
| Former Name | CASSIE ABIGAIL WILLIS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WV PT004046) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: SC 6196) |
| Enumeration Date | 2010-06-22 |
| Last Update Date | 2022-11-05 |