| NPI | 1962878397 |
|---|---|
| Former Name | KATHLEEN PORTER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CO PTL.0011879) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WY PT 1454) |
| Enumeration Date | 2015-08-20 |
| Last Update Date | 2015-08-20 |