NPI | 1710615836 |
---|---|
Former Name | JENNIFER R SMITH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: AL 11683R) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: FL PT39016) |
Enumeration Date | 2022-08-09 |
Last Update Date | 2023-11-28 |