| NPI | 1629403886 |
|---|---|
| Former Name | MEAGAN E KELLY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NV 4300) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: NV A-1169) |
| Enumeration Date | 2013-09-06 |
| Last Update Date | 2020-06-09 |