| NPI | 1649842022 |
|---|---|
| Former Name | ANDREA JAMESON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2021-07-14 |
| Last Update Date | 2021-08-16 |