| NPI | 1699301127 |
|---|---|
| Former Name | JESSA TAYLOR RENNIE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: TX 2000038435) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer |
| Enumeration Date | 2020-03-16 |
| Last Update Date | 2020-07-13 |