Individual
KAELEIGH BRISLIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1255 W BASELINE RD, MESA, AZ 85202-5820
(480) 820-7675
Mailing address
172 HILLCREST AVE, HAWTHORNE, NJ 07506-3046
(862) 290-0537
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
40QA02191700
NJ
Other
Enumeration date
09/06/2023
Last updated
09/06/2023
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