| NPI | 1073088183 |
|---|---|
| Former Name | JENNIFER SOURYCHACK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: HI 9338) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: AZ 23504) |
| Enumeration Date | 2018-10-05 |
| Last Update Date | 2019-06-12 |