| NPI | 1689616179 |
|---|---|
| Former Name | KELLY M JOHNSTON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: DE J10001378) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: PA PT006924L) |
| Enumeration Date | 2006-06-11 |
| Last Update Date | 2013-03-05 |