| NPI | 1760779334 |
|---|---|
| Former Name | CALLIE PAIGE MOSIMAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: KS 11-04253) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MO 20-11018907) |
| Enumeration Date | 2011-07-05 |
| Last Update Date | 2018-05-08 |