| NPI | 1780926105 |
|---|---|
| Former Name | MICHELLE RENEE PREWITT |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OK 5012) |
| Additional Taxonomies | 2251X0800X Physical Therapist Orthopedic (Licence: MO 2013008000) |
| 2251X0800X Physical Therapist Orthopedic (Licence: KS 11-04532) | |
| Enumeration Date | 2013-03-24 |
| Last Update Date | 2017-05-25 |