| NPI | 1861663023 |
|---|---|
| Former Name | KRISTIE L GRAVEL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IL 070-016288) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IA 004225) |
| Enumeration Date | 2008-03-17 |
| Last Update Date | 2012-04-11 |