| NPI | 1720513476 |
|---|---|
| Former Name | JESSICA LYNN LAVIOLETTE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 204D00000X Neuromusculoskeletal Medicine & OMM (Licence: ME DO3061) |
| Enumeration Date | 2017-05-01 |
| Last Update Date | 2024-06-18 |