| NPI | 1700293040 |
|---|---|
| Former Name | KAITLIN REYNOLDS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MD 25359) |
| Enumeration Date | 2014-07-18 |
| Last Update Date | 2020-08-24 |