| NPI | 1487038337 |
|---|---|
| Former Name | JESSICA CANALES |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OK 5028) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TX 1258423) |
| Enumeration Date | 2015-07-09 |
| Last Update Date | 2020-08-10 |