NPI | 1679818793 |
---|---|
Former Name | KILEY ROSE ZELLITTI |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: ID PT-6736) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: MD 25568) |
225100000X Physical Therapist (Licence: WA PT60363672) | |
Enumeration Date | 2012-11-29 |
Last Update Date | 2020-05-21 |