| NPI | 1083013718 |
|---|---|
| Former Name | JENNIFER DEBOER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: AZ 11104) |
| Additional Taxonomies | 2251S0007X Physical Therapist Sports |
| 2251X0800X Physical Therapist Orthopedic | |
| Enumeration Date | 2014-08-19 |
| Last Update Date | 2015-09-15 |