| NPI | 1780083055 |
|---|---|
| Former Name | BRENDA LYNN BOLDING |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: KS 11-04854) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MO 2015003001) |
| Enumeration Date | 2014-08-22 |
| Last Update Date | 2015-02-19 |