| NPI | 1952564221 |
|---|---|
| Former Name | STACY SUE WHIGHAM |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IN 05003254A) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CO 0002894) |
| Enumeration Date | 2008-07-08 |
| Last Update Date | 2021-06-11 |