| NPI | 1659520609 |
|---|---|
| Former Name | JAMIE C DERNER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WY PT-984) |
| Additional Taxonomies | 2251X0800X Physical Therapist Orthopedic |
| Enumeration Date | 2008-09-15 |
| Last Update Date | 2018-11-02 |