| NPI | 1124377221 |
|---|---|
| Former Name | JACQUELINE D SPIES |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MO 2012027769) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IL 070.019678) |
| Enumeration Date | 2012-09-05 |
| Last Update Date | 2020-07-09 |