| NPI | 1912290206 |
|---|---|
| Former Name | KACI LEE CALAWAY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MT 2406) |
| Additional Taxonomies | 261QP2000X Clinic/Center, Physical Therapy |
| Enumeration Date | 2011-05-19 |
| Last Update Date | 2016-05-26 |