| NPI | 1043703143 |
|---|---|
| Former Name | JESSICA LYLES |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: SC 9151) |
| Additional Taxonomies | 225100000X Physical Therapist |
| Enumeration Date | 2018-06-13 |
| Last Update Date | 2020-02-20 |