| NPI | 1851514442 |
|---|---|
| Former Name | STACY MARIE KOMMER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MI 5501013320) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL 23166) |
| Enumeration Date | 2007-04-11 |
| Last Update Date | 2013-07-16 |