| NPI | 1285074187 |
|---|---|
| Former Name | JESSICA WITTHOFT |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MO 2013028761) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IL 070021414) |
| Enumeration Date | 2013-06-25 |
| Last Update Date | 2017-03-13 |