| NPI | 1588113674 |
|---|---|
| Former Name | JENNIFER DEETER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NC P16972) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WI 13072-24) |
| Enumeration Date | 2016-09-29 |
| Last Update Date | 2019-11-04 |