| NPI | 1710656889 |
|---|---|
| Former Name | JENNIFER LYNNE ANDERSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MS CP022518T) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: VA 2305214677) |
| Enumeration Date | 2021-09-10 |
| Last Update Date | 2023-08-07 |