NPI | 1922350180 |
---|---|
Former Name | MCKENZE SCHULTZ |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: IA 080936) |
Additional Taxonomies | 2251X0800X Physical Therapist, Orthopedic (Licence: MN 8461) |
Enumeration Date | 2012-10-11 |
Last Update Date | 2021-08-17 |