| NPI | 1457744187 |
|---|---|
| Former Name | JENNIFER CUSICK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NC P17050) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL 29951) |
| Enumeration Date | 2015-03-04 |
| Last Update Date | 2018-10-21 |