NPI | 1801419544 |
---|---|
Former Name | SHELBY LYNN STOLTZ |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: ID PT-6876) |
Additional Taxonomies | 2251S0007X Physical Therapist, Sports (Licence: ID PT-6876) |
2251X0800X Physical Therapist, Orthopedic (Licence: ID PT-6876) | |
Enumeration Date | 2020-05-27 |
Last Update Date | 2020-06-13 |