| NPI | 1720337892 |
|---|---|
| Former Name | ERICA MARIE REYNOLDS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CO 0012437) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: KY 006092) |
| Enumeration Date | 2012-09-05 |
| Last Update Date | 2014-02-13 |