| NPI | 1649787136 |
|---|---|
| Former Name | ALEXIS NICOLE MERGER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: AZ 13563) |
| Additional Taxonomies | 225100000X Physical Therapist |
| Enumeration Date | 2018-01-05 |
| Last Update Date | 2019-08-21 |