| NPI | 1578978789 |
|---|---|
| Former Name | KAITLYN MARIE FRY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: AR PT4658) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: GA CP005096T) |
| Enumeration Date | 2014-06-25 |
| Last Update Date | 2022-11-03 |