| NPI | 1225580673 |
|---|---|
| Former Name | JESSICA NICOLE CUNNINGHAM |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: AL PTH9921) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer |
| Enumeration Date | 2016-11-02 |
| Last Update Date | 2021-08-18 |