NPI | 1689639718 |
---|---|
Former Name | JENNEIFER CHARRON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 225100000X Physical Therapist (Licence: NJ 40QA01571000) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: AR PT2755) |
2251S0007X Physical Therapist, Sports (Licence: AR PT2755) | |
2251X0800X Physical Therapist, Orthopedic (Licence: AR PT2755) | |
Enumeration Date | 2006-04-20 |
Last Update Date | 2023-03-28 |