NPI | 1740666783 |
---|---|
Former Name | KELLY HOFFMANN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: IN 05013765A) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: MO 2015027172) |
Enumeration Date | 2015-07-31 |
Last Update Date | 2022-03-09 |