| NPI | 1750879102 |
|---|---|
| Former Name | CALEY LYNN BLAIR |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MO 2018020359) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: KS 11-05855) |
| Enumeration Date | 2018-05-01 |
| Last Update Date | 2021-04-09 |