| NPI | 1932405446 |
|---|---|
| Former Name | KELLY PATTON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MO 2023036863) |
| Additional Taxonomies | 2251X0800X Physical Therapist, Orthopedic (Licence: CO 11022) |
| Enumeration Date | 2011-01-31 |
| Last Update Date | 2023-09-12 |