| NPI | 1518347079 |
|---|---|
| Former Name | JACLYN RAGAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IL 070-022097) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: OK 4918) |
| Enumeration Date | 2015-05-31 |
| Last Update Date | 2024-05-01 |