| NPI | 1689191694 |
|---|---|
| Former Name | JORDON BETH DAVIS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MS PT6570) |
| Additional Taxonomies | 225100000X Physical Therapist |
| Enumeration Date | 2017-08-30 |
| Last Update Date | 2018-10-04 |