| NPI | 1437403219 |
|---|---|
| Former Name | JENNAFER ASHLEY WAGNER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: DE J1-0002934) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MD 24279) |
| Enumeration Date | 2012-11-01 |
| Last Update Date | 2022-08-31 |