| NPI | 1710378815 |
|---|---|
| Former Name | JESSICA MARIE COREY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL PT33785) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: FL AL3821) |
| Enumeration Date | 2015-02-10 |
| Last Update Date | 2018-08-13 |