| NPI | 1194140244 |
|---|---|
| Former Name | JORDAN R GALLES |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IA 072794) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IL 070020563) |
| Enumeration Date | 2014-02-26 |
| Last Update Date | 2021-03-31 |