| NPI | 1447500814 |
|---|---|
| Former Name | JENA LYNN JENKINS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WI 12150-24) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL PT-27753) |
| Enumeration Date | 2012-09-13 |
| Last Update Date | 2018-12-07 |