| NPI | 1598283731 |
|---|---|
| Former Name | CHELSEY PROVENCHER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NJ 40QA01901700) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: PA PT026270) |
| Enumeration Date | 2017-09-08 |
| Last Update Date | 2024-03-14 |