NPI | 1558724120 |
---|---|
Former Name | JESSICA HELEN CALDWELL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: VA 2306602400) |
Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: CA 8799) |
Enumeration Date | 2016-03-31 |
Last Update Date | 2016-03-31 |