NPI | 1558710558 |
---|---|
Former Name | JENNA FITZSIMMONS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: RI PT02937) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: MA 22929) |
Enumeration Date | 2016-06-09 |
Last Update Date | 2024-02-29 |