| NPI | 1619610789 |
|---|---|
| Former Name | JESSICA RUTH KEEFE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: SC 4624) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: FL 30696) |
| Enumeration Date | 2022-04-18 |
| Last Update Date | 2022-04-18 |