| NPI | 1700446721 |
|---|---|
| Former Name | CARLY MICHELLE SLAGEL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251X0800X Physical Therapist, Orthopedic (Licence: MO 2019031259) |
| Additional Taxonomies | 225100000X Physical Therapist |
| 2251X0800X Physical Therapist, Orthopedic (Licence: KS 11-06393) | |
| Enumeration Date | 2019-06-20 |
| Last Update Date | 2023-03-07 |