NPI | 1275965626 |
---|---|
Former Name | JESSICA MICHELE ISACSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: FL PT32493) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: AL PTH 6911) |
Enumeration Date | 2013-08-07 |
Last Update Date | 2017-05-09 |