NPI | 1205369063 |
---|---|
Former Name | JESSICA RUBY OSBORNE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: MD 29158) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: SC 8560) |
225100000X Physical Therapist (Licence: NC 16506) | |
225100000X Physical Therapist (Licence: HI 4829) | |
225100000X Physical Therapist (Licence: TX 1284626) | |
Enumeration Date | 2017-04-09 |
Last Update Date | 2022-12-14 |