| NPI | 1376964726 |
|---|---|
| Former Name | JESSICA L BLAHUT |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MD 25914) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NJ 40QA01531000) |
| Enumeration Date | 2014-01-01 |
| Last Update Date | 2018-09-06 |