| NPI | 1033509765 |
|---|---|
| Former Name | JESSICA MILLER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NC P15387) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TX P15387) |
| Enumeration Date | 2015-02-03 |
| Last Update Date | 2023-02-02 |