NPI | 1790315992 |
---|---|
Former Name | KAYLEA DAVIS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: AL PTH9968) |
Additional Taxonomies | 2251X0800X Physical Therapist, Orthopedic |
Enumeration Date | 2020-01-16 |
Last Update Date | 2025-05-19 |