| NPI | 1659426724 |
|---|---|
| Former Name | JODI BELISLE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NH 2776) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: VT 3287) |
| Enumeration Date | 2007-01-25 |
| Last Update Date | 2007-07-08 |