| NPI | 1184013096 |
|---|---|
| Former Name | JEAN ROTH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IL 070022307) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: OR 60831) |
| 225100000X Physical Therapist (Licence: MN 9415) | |
| 225100000X Physical Therapist (Licence: CA 42133) | |
| 225100000X Physical Therapist (Licence: TX 1238483) | |
| Enumeration Date | 2015-01-15 |
| Last Update Date | 2017-03-29 |