NPI | 1497176101 |
---|---|
Former Name | JACQUELINE ANN STEWART |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 032924-1) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: MA 21432) |
225100000X Physical Therapist (Licence: VT 040.0071130) | |
2251C2600X (Licence: NY 032924-1) | |
2251G0304X Physical Therapist, Geriatrics (Licence: NY 032924-1) | |
2251X0800X Physical Therapist, Orthopedic (Licence: NY 032924-1) | |
Enumeration Date | 2013-12-23 |
Last Update Date | 2023-05-10 |