| NPI | 1225149099 |
|---|---|
| Former Name | KIMBERLEE JACOB |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: UT 341950-2401) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WA PT00008326) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2015-04-22 |