| NPI | 1730205204 |
|---|---|
| Former Name | SHELLY EDWARDS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WA PT00009283) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CA PT25490) |
| Enumeration Date | 2007-03-22 |
| Last Update Date | 2012-09-07 |