| NPI | 1376949719 |
|---|---|
| Former Name | STEPHANIE JONES |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IL 070024752) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist Athletic Trainer (Licence: IL 096003393) |
| Enumeration Date | 2014-11-12 |
| Last Update Date | 2024-05-08 |