| NPI | 1649423849 |
|---|---|
| Former Name | BRANDIS K BOLIN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: GA 009891) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: KY 005353) |
| Enumeration Date | 2008-10-31 |
| Last Update Date | 2017-02-24 |