| NPI | 1700315736 |
|---|---|
| Former Name | JENNIFER SQUIRES |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL PT32539) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: FL PTT32539) |
| Enumeration Date | 2017-06-04 |
| Last Update Date | 2022-10-25 |