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Individual
KAIRA LEE FETLA
Active
Individual
KAIRA LEE FETLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
046960
NY
225100000X
Physical Therapist
PT014186
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
046960
LICENSE
NY
Enumeration date
08/02/2019
Last updated
11/04/2021
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