| NPI | 1053508697 |
|---|---|
| Former Name | JENNIFER LEE TJEERDSMA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IA 105915) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: AZ 7848) |
| 225100000X Physical Therapist (Licence: NE 2910) | |
| Enumeration Date | 2007-09-27 |
| Last Update Date | 2021-05-11 |