| NPI | 1497148282 |
|---|---|
| Former Name | JENNIFER LYNN SHOEMAKE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: GA PT014360) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MO 2013028491) |
| 225100000X Physical Therapist (Licence: KS 11-05149) | |
| Enumeration Date | 2015-03-18 |
| Last Update Date | 2019-09-24 |