| NPI | 1881256477 |
|---|---|
| Former Name | KATE BUBOLTZ |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MT 19179) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: ND 2326) |
| 225100000X Physical Therapist (Licence: MN 11647) | |
| Enumeration Date | 2019-07-03 |
| Last Update Date | 2020-06-10 |