| NPI | 1629114459 |
|---|---|
| Former Name | JENNIFER LYNN LEWIS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305831271) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: DC 2972) |
| 225100000X Physical Therapist (Licence: MD 19512) | |
| Enumeration Date | 2007-01-29 |
| Last Update Date | 2022-07-21 |