| NPI | 1629632005 |
|---|---|
| Former Name | KAILEY MARIE MCCASTLE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MI 5501302460) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: MI 5502005172) |
| Enumeration Date | 2019-05-01 |
| Last Update Date | 2025-01-10 |