| NPI | 1609505452 |
|---|---|
| Former Name | JENNA POISEL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CO PTL.0019885) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WA PT61305877) |
| Enumeration Date | 2022-06-07 |
| Last Update Date | 2024-06-05 |