| NPI | 1659705663 |
|---|---|
| Former Name | MALLORY BETH BROWN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174400000X Specialist (Licence: AR PT 3737) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: AR PT3737) |
| Enumeration Date | 2013-08-27 |
| Last Update Date | 2022-06-30 |