| NPI | 1528481736 |
|---|---|
| Former Name | JENNA WOODFORD |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WY 1519) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NE 2336) |
| Enumeration Date | 2014-01-23 |
| Last Update Date | 2014-01-23 |