| NPI | 1700063385 |
|---|---|
| Former Name | KRISTEN MCCALL THAYER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: SC 5662) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: SC 897) |
| Enumeration Date | 2008-01-26 |
| Last Update Date | 2008-01-26 |