NPI | 1720124357 |
---|---|
Former Name | JENNIFER LEE BERTAGNI |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: WA PT00010288) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: AZ 7452) |
Enumeration Date | 2007-01-30 |
Last Update Date | 2023-11-14 |