| NPI | 1578996187 |
|---|---|
| Former Name | STEPHANIE SUE KOHLWEY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NE 3283) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL 30722) |
| Enumeration Date | 2013-08-19 |
| Last Update Date | 2015-09-15 |