NPI | 1275898421 |
---|---|
Former Name | JENNIFER M BREITHAUPT |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2251X0800X Physical Therapist, Orthopedic (Licence: MD 25802) |
Additional Taxonomies | 2251X0800X Physical Therapist, Orthopedic (Licence: PA PT022075) |
Enumeration Date | 2012-07-12 |
Last Update Date | 2024-03-26 |