NPI | 1144997214 |
---|---|
Former Name | JENNIFER WENGER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305214941) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: CA 299694) |
225100000X Physical Therapist (Licence: MO 2025041305) | |
Enumeration Date | 2021-08-26 |
Last Update Date | 2025-09-23 |