| NPI | 1790192268 |
|---|---|
| Former Name | CHRISTINE NICOLE CONNELLY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: DE J1-0003337) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: OR 60515) |
| Enumeration Date | 2014-07-16 |
| Last Update Date | 2016-02-23 |