NPI | 1659883569 |
---|---|
Former Name | JESSICA BOWERS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 225100000X Physical Therapist (Licence: OR 63508) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: NC P17565) |
Enumeration Date | 2017-11-01 |
Last Update Date | 2023-09-21 |