| NPI | 1649347766 |
|---|---|
| Former Name | SHAUNA R CARLISLE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IA 077423) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IL 070012198) |
| Enumeration Date | 2006-11-30 |
| Last Update Date | 2016-07-27 |