| NPI | 1992253397 |
|---|---|
| Former Name | AMY KATHRYN MELLANG |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MN 10943) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WI 14519) |
| 2251C2600X Physical Therapist, Cardiopulmonary (Licence: TX 1278467) | |
| Enumeration Date | 2016-09-14 |
| Last Update Date | 2022-04-21 |