| NPI | 1033660691 |
|---|---|
| Former Name | JESSICA ELIZABETH TEATER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OH PT018748) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WA 60666846) |
| 225100000X Physical Therapist (Licence: OR 61669) | |
| Enumeration Date | 2016-10-19 |
| Last Update Date | 2020-07-01 |