| NPI | 1639335508 |
|---|---|
| Former Name | MICHELLE L BALLANTYNE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: PA PT019481) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: DE J1-0003874) |
| 2251S0007X Physical Therapist, Sports | |
| 2251X0800X Physical Therapist, Orthopedic | |
| Enumeration Date | 2008-07-31 |
| Last Update Date | 2018-11-28 |