| NPI | 1639688781 |
|---|---|
| Former Name | JOELLE STUTTS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2081S0010X Physical Medicine & Rehabilitation, Sports Medicine (Licence: FL PT7049) |
| Enumeration Date | 2017-09-20 |
| Last Update Date | 2022-05-06 |