| NPI | 1821513979 |
|---|---|
| Former Name | SHANNA JADE PALMER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 225100000X Physical Therapist |
| Enumeration Date | 2017-08-10 |
| Last Update Date | 2017-08-10 |