| NPI | 1306113675 |
|---|---|
| Former Name | JENNY RAE MINNICH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CA PT 37053) |
| Additional Taxonomies | 174400000X Specialist (Licence: CA PT 37053) |
| Enumeration Date | 2011-11-30 |
| Last Update Date | 2015-05-06 |