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 |