| NPI | 1629564372 |
|---|---|
| Former Name | KELSI LYN MARTIN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MO 2018025702) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: KS 11-05949) |
| Enumeration Date | 2018-07-05 |
| Last Update Date | 2022-07-06 |