| NPI | 1558739417 |
|---|---|
| Former Name | JESSICA WATERMAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OH PT016004) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IN 05011892A) |
| Enumeration Date | 2015-09-09 |
| Last Update Date | 2021-08-10 |