NPI | 1720334295 |
---|---|
Former Name | ALISSA JEAN KRAJECKI |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2251X0800X Physical Therapist, Orthopedic (Licence: CO PTL.0011823) |
Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: CO AT.0001073) |
Enumeration Date | 2012-08-01 |
Last Update Date | 2024-09-06 |