| NPI | 1801569199 |
|---|---|
| Former Name | OLIVIA KAY MCDONOUGH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 2251X0800X Physical Therapist, Orthopedic (Licence: IL 070.025846) |
| Enumeration Date | 2021-08-01 |
| Last Update Date | 2022-11-11 |