| NPI | 1649799602 |
|---|---|
| Former Name | BRENNA MARIE PRIEST |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MD 27439) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NC P19528) |
| Enumeration Date | 2017-09-11 |
| Last Update Date | 2024-11-19 |