| NPI | 1740208420 |
|---|---|
| Former Name | JESSICA CATHLEEN WILLEY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MN 7625) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: OH 10220) |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2007-07-08 |