| NPI | 1790072577 |
|---|---|
| Former Name | SHELLEY ANNE WAYMAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CO PTL.0013395) |
| Additional Taxonomies | 2251X0800X Physical Therapist Orthopedic (Licence: AZ 10364) |
| 225100000X Physical Therapist (Licence: WA 60227242) | |
| 225100000X Physical Therapist (Licence: AZ 10364) | |
| Enumeration Date | 2011-06-30 |
| Last Update Date | 2017-03-15 |