| NPI | 1710277801 |
|---|---|
| Former Name | CARLY ONKOTZ WHEATON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: PA PT021194) |
| Additional Taxonomies | 225100000X Physical Therapist |
| Enumeration Date | 2011-04-11 |
| Last Update Date | 2021-12-16 |