| NPI | 1982468757 |
|---|---|
| Former Name | EMMA C KELLY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MN 13641) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CO PTLP.0000328) |
| Enumeration Date | 2024-02-12 |
| Last Update Date | 2024-09-30 |