| NPI | 1720238553 |
|---|---|
| Former Name | MELLONY JUNE MEISTER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: KS 11-04815) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: MO 2008028214) |
| Enumeration Date | 2008-09-29 |
| Last Update Date | 2018-08-15 |